On Organ Donation

[JohnK]

There has been a lot of discussion/speculation on this topic.

Was this from a movie or TV series? What if you are an organ donor and you have had a serious accident and your condition is critical. Someone needs your organs. Do they persevere trying to keep you alive on life support or try to save other lives?

Then there is the story a couple of weeks ago of 2 fathers given kidneys from an alcoholic that were infected with a parasitic worm.

 

[UP4014]

I agree with you. I do however think from an ethical standpoint, it's difficult to see how an individual would be prepared to accept organ donation given freely by consent from the grieving family of another individual but not be prepared to give the same consent if the roles were reversed. Quite unconscionable to me actually.

How about I put it this way.

Do you disagree with my view that all people in Australia should be afforded the exact same level of health care regardless of the personal decisions they make in life?

Matt

 

[Pushka]

How about I put it this way.

Do you disagree with my view that all people in Australia should be afforded the exact same level of health care regardless of the personal decisions they make in life?

Matt

Interesting question that.

 

[UP4014]

There has been a lot of discussion/speculation on this topic.

Was this from a movie or TV series? What if you are an organ donor and you have had a serious accident and your condition is critical. Someone needs your organs. Do they persevere trying to keep you alive on life support or try to save other lives?

I would expect that this has certainly happened, a nearly deceased person and someone desperate for a life saving organ. Plenty of potential problems with medical ethics, forget the theory and look at reality.

Matt

 

[drron]

There has been a lot of discussion/speculation on this topic.

Was this from a movie or TV series? What if you are an organ donor and you have had a serious accident and your condition is critical. Someone needs your organs. Do they persevere trying to keep you alive on life support or try to save other lives?

Then there is the story a couple of weeks ago of 2 fathers given kidneys from an alcoholic that were infected with a parasitic worm.

That is the link QF WP made.As I said the donor was only the 6th person in the world to have had that infection.Basically more chance of your plane being brought down by a meteor.

How about I put it this way.

Do you disagree with my view that all people in Australia should be afforded the exact same level of health care regardless of the personal decisions they make in life?

Matt

They already do get the same level of care.

 

[JohnK]

That is the link QF WP made.As I said the donor was only the 6th person in the world to have had that infection.Basically more chance of your plane being brought down by a meteor.

No consolation though as it did happen. How did the organs get on the donor list without being thorougly tested?

 

[UP4014]

That is the link QF WP made.As I said the donor was only the 6th person in the world to have had that infection.Basically more chance of your plane being brought down by a meteor.
They already do get the same level of care.

drron, you're answering a question I didn't ask.

Matt

 

[drron]

drron, you're answering a question I didn't ask.

Matt

Just making it definite that the Australian Medical profession agrees with you view.

 

[Princess Fiona]

How about I put it this way.

Do you disagree with my view that all people in Australia should be afforded the exact same level of health care regardless of the personal decisions they make in life?

Matt

No, I agree with that view.

 

[Princess Fiona]

Was this from a movie or TV series? What if you are an organ donor and you have had a serious accident and your condition is critical. Someone needs your organs. Do they persevere trying to keep you alive on life support or try to save other lives?
.

You can't be considered for organ donation unless you are dead.

Critical doesn't come into it at all.

 

[tuapekastar]

You can't be considered for organ donation unless you are dead.

Not necessarily.

https://www.youtube.com/watch?v=aclS1pGHp8o

 

[k_sheep]

That begs the question though - what protocols are in place to screen the patients medical history for illnesses that may preclude use of their organs (thinking about the more common ones than this rare condition that could not have been foreseen, prior to the ME's/Coroners pick-up later).

I think my organ are healthy, I have always eaten with a mind towards non-excessive intake of saturated fats, moderate intake of red wine and exercise.

Very strict and rigorous protocols are in place for testing the donor - in my lab, this is why we have serology (antibody testing) and molecular (DNA testing) scientists and pathologists on call 24/7 for testing in case of potential organ donors.

Guidelines are available at http://www.donatelife.gov.au/sites/default/files/files/TSANZ_Consensus_Statement_V1_1.pdf - page 32 for the infectious screening recommendations. For QLD at least, we do all the mandatory and all of the recommended except for bhCG and postmortem - though this is more often done than not. Note that risk factors are also taken into account, and again, microbiologists and infectious diseases specialists are always contacted in the event of potential donors.

 

[QF WP]

thanks k_sheep, very informative and lays to rest some niggling concerns (not for me donating, but being a recipient or having a family member)

 

[k_sheep]

There's also some interesting quirks - for example, a donor with Hepatitis C virus can still donate to other Hep C patients, provided they have a similar virus profile. Bone marrow donors (generally live donations) don't need to be the same blood type as the recipient. It's a really interesting field of medicine.

 

[artemis]

Re: The totally off-topic thread

I don't believe in "opt out" for donation either as it impacts on those who might not understand they have to actively manage this. And I'm sick of Government legislation that interferes with personal decisions. I'm becoming somewhat anarchist as I get older.

This decision must be left up to the person prior if possible and the family during the process if not.

If you're concerned about the comprehension and informed consent of the population, I would point out that they're also equally impacted by opt-in donation clauses. Unfamiliarity with a topic works both in the positive and the negative.

I think you'll find that the Government legislates to improve the benefit to the community. It may not personally benefit you, but the community in which you live will benefit. Drink driving laws: would be much more convenient for me to drive home with a BAC of 0.08% (I don't do this for the record), but puts other people at risk... Not the greatest example in the world, I know.

 

[artemis]

Re: The totally off-topic thread

I guess I don't understand either side of organ donation enough to make a decision about it, apart from the fact that donated organs can be used for transplants. All said and done, I'm not exactly the healthiest male around; if there's a catalogue for organ recipients looking for donors (in a similar way to looking up sperm donors), then like hell anyone is going to want my heart, for a start.

That is why my donor status, when it was still shown and indicated on the drivers licence, was "undecided".

Two things:

1. Happy to provide education as to organ donation and organ transplantation if you want to understand more.

2. You may not think you're the healthiest bloke around, but without knowing you, you're healthier than the patient on dialysis, or the patient with the bi-ventricular pump device, or the patient on ECMO... (unless you're on one of these machines!). That's why your organs might be of benefit!

 

[Pushka]

Re: The totally off-topic thread

If you're concerned about the comprehension and informed consent of the population, I would point out that they're also equally impacted by opt-in donation clauses. Unfamiliarity with a topic works both in the positive and the negative.

I think you'll find that the Government legislates to improve the benefit to the community. It may not personally benefit you, but the community in which you live will benefit. Drink driving laws: would be much more convenient for me to drive home with a BAC of 0.08% (I don't do this for the record), but puts other people at risk... Not the greatest example in the world, I know.

Yep. But in life and death situations involving loved ones I'm not sure how many people really give "the community" a thought.

 

[artemis]

Mandatory organ donation?

I'd like to be able to choose whether I would donate my organs or not instead of the choice being automatically made for me and then I have to opt-out of organ donation.

I have already chosen. I didn't require any thought. You wouldn't want my organs anyway.

Look, to be very clear - an opt-out system is not mandatory organ donation.

The majority of people die in a manner that is not conducive for organ donation.

The aim of an opt-out system is to change the culture surrounding organ donation - to lift the veil and make it commonplace (well, more commonplace). Many people have mentioned on this board that when a loved one is dying it's a stressful time. Which it is! Opt-out simply removes the burden of having to say yes to organ donation from the family.

However, as it stands today, even if you say yes, if your family say no, you don't get to be an organ donor.

And as for your organs and would they be suitable? You'd be surprised at what we use in kidney transplants, because it sure beats the hell out of dialysis!

 

[artemis]

That begs the question though - what protocols are in place to screen the patients medical history for illnesses that may preclude use of their organs (thinking about the more common ones than this rare condition that could not have been foreseen, prior to the ME's/Coroners pick-up later).

I think my organ are healthy, I have always eaten with a mind towards non-excessive intake of saturated fats, moderate intake of red wine and exercise.

Organ donation questionnaires are pretty detailed and target certain at risk behaviours/histories. They are only as good as the person giving the information, and as a general rule, they work pretty well.

Yes, rare infections can kill people post-transplantation. But common infections kill people post-transplantation much more commonly, I'm afraid. It's called immunosuppression and it's pretty potent. Recipients are warned of the attendant risks of transplantation and immunosuppression and counselled very thoroughly.

People who are waiting for heart/lung/liver transplants are often within days/weeks of dying, so transplant is a pretty easy decision I would think.

 

[artemis]

I think it is up to my relatives to do what they think is best for them, as they are the ones who have to cope with me passing away.

Given the rigorous testing by the Red Cross for blood donations, I'd like to think the same thing happens with organ donation, but I wonder if questions relating to issues like CJD are asked. And at a time of imminent death if it is a time to ask the distressed anyway.

Uh yes, of course CJD is considered. Along with a whole bunch of other potential infections/malignancies.

And yes, it's the next-of-kin who are asked.

Donation Specialist Nurses are employed in most ICUs in the country and are very well trained at asking difficult questions and providing support at very difficult times. They really are pretty terrific at their job and do it in a very sensitive manner.

We have entire conferences dedicated to organ and tissue donation protocols - it's a super-interesting area, with a strong ethics focus. Probably one of the best areas of medicine to formally discuss ethics at international meetings (as opposed to say, oncology meetings).