Module 8: One Legacy Organ Donation WHY ONELEGACY

Module 8: One Legacy Organ Donation WHY ONELEGACY IS NEEDED More than 121,000 on national waiting list 20 on waiting list die each day Another name is added to the list every 13 minutes WHO IS ONELEGACY

Not-for-profit Organ Procurement Organization (OPO) and Tissue Recovery Agency Federally designated and funded Accredited by Association of Organ Procurement Organizations, Eye Bank Association of America & American Association of Tissue Banks WHO IS ONELEGACY Established to: Educate the public about benefits of organ & tissue donation and transplantation Recover, preserve and distribute donated organs & tissues

Increase the availability of organs & tissues for transplantation TRANSPLANTABLE ORGANS & TISSUES Kidneys Liver Heart Lungs Pancreas Sm. Intestine TISSUES

ORGANS

Cornea/Eyes Heart Valves Skin Bone Tendons Cartilage Veins ORGAN & TISSUE DONOR CRITERIA

Donation criteria often changes NO ONE SHOULD BE RULED OUT Refer All Ages Regardless of Medical History Even patients is under Medical Examiner / Coroners Jurisdiction Patients with Advanced Directives (even those objecting to donation) IDENTIFYING A POTENTIAL ORGAN & TISSUE DONOR Organ Donor Potential Ventilated with a devastating illness or injury and one or more of the following: Family considering DNR

Prior to Withdrawal of ventilator Loss of one or more brainstem reflexes Pupils fixed No Cough or Gag reflex No response to painful stimuli No spontaneous respirations Tissue Donor Potential All deaths must be referred to OneLegacy within one hour of cardiopulmonary arrest HIPAA PRIVACY RULE ON ORGAN & TISSUE DONATION CFR 164.512(h) -- Final Rule: A covered entity may use or disclose PHI to OPOs or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes or tissue for the purpose of facilitating organ, eye or tissue donation and

transplantation. POTENTIAL DONOR EVALUATION Tissue Donors Organ Donors All deaths are reported to OneLegacy During the referral, the caller will provide all clinical information requested

The plan of care and status of the patient OneLegacy will determine tissue donation suitability Plans for or family mentions of withdrawal of life-sustaining measures An onsite evaluation will be performed to identify Plans for possible brain stem testing BRAIN DEATH VS DONATION AFTER CARDIAC DEATH (DCD) Brain Death

DCD Ventilator dependent Ventilator dependent No brain stem reflexes Minimal brain stem reflexes Unable to maintain own vital functions Cardiac arrest is unavoidable Cannot maintain vital functions without support Cardiac arrest is unavoidable. FAMILY SUPPORT

Physician explains brain death and tests Do Not Mention Donation Bridging statement example for hospital personnel Someone will be coming in to speak with you regarding end of life decisions that you will need to make.