KIDNEY DONATION

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KIDNEY DONATION

• FORTUNATO M. RAMONAL, JR.,MD.,CSE
• REDCOP Regional Coordinator

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WHAT ARE THE BENEFITS OF ORGAN DONATION?

• Saving lives organ transplantation gives people
  who would otherwise die a second chance to live
• Quality of life for people who depend upon
  dialysis machines, it means the return to a
  normal, productive lifestyle
• Cost effectiveness organ transplantation can be
  more economical on the long term than other forms
  of medical treatment

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WHO CAN BE A DONOR?

• Kidneys for transplantation may come from
• Living donor
• Cadaver donor
• A kidney from living donor is more desirable than
  a cadaver

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LIVING KIDNEY DONORS
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WHY ARE LIVING DONOR KIDNEYS PREFERABLE?

• Kidneys from live donors are removed under ideal
  conditions and the donor is expected to be in
  optimal health. When these conditions are met,
  the donated kidneys usually function immediately
  and the occurrence of rejection is less likely.
• The recipient experiences better kidney
  functions for a longer period of time

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WHO CAN BE A LIVING DONOR?

• healthy person age 18-60 years old, whose blood
  type and HLA tissue typing are compatible with
  the recipient
• The donation must be a voluntary act
• A related donor is a blood relative parent,
  offspring, sibling, half-sibling, aunt, uncle or
  cousin

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CAN NON-RELATED INDIVIDUALS DONATE KIDNEYS?

• If a blood relative is unable to donate, a spouse
  or an emotionally related person maybe
  considered.
• In these cases, careful consideration is given to
  such factors as the motives, long-term emotional
  bonds, and the psychological implications for
  both donor and recipient

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WHAT MAKES A GOOD MATCH BETWEEN A KIDNEY DONOR
AND RECIPIENT?

• when the donor and recipient have compatible
  blood types and share similar genes
• The more closely related two people are the more
  likely their blood and body tissues will be alike

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HOW IS A DONOR EVALUATED?

• Donor should be in good general health and has
  good renal function
• To determine the health of the donor, several
  routine tests are conducted
• Complete history and PE
• Blood type and tissue typing
• Blood, urine and viral testing
• Ultrasound of kidneys
• Chest x-ray
• Arteriogram of the kidneys
• An interview with the social worker and
  psychiatrist to ensure there is a healthy motive
  to donate

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IS A DONOR MORE LIKELY TO DEVELOP KIDNEY DISEASE
OR OTHER HEALTH PROBLEMS LATER IN LIFE?

• At present, kidney donation does not seem to
  place an individual at higher risk for future
  health problems

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CADAVER KIDNEY DONORS
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WHO MANAGES ORGAN DONATION AFTER DEATH?

• HOPE (Human Organ Preservation Effort) at NKTI is
  the non-profit organ donation program created to
  manage all cadaver organ donations for
  transplantation

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WHAT ORGANS ARE APPROPRIATE FOR DONATION?

• Organs that can be donated are
• Heart
• Liver
• Kidneys
• Lungs
• Pancreas
• Corneas
• intestines

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WHAT ARE THE CRITERIA FOR BECOMING AN ORGAN DONOR?

• Organs can be donated only after a person has
  been declared brain dead while his vital organs
  are being maintained on a breathing machine
• Organ donors can be anyone including newborns up
  to age 75

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WHAT IS BRAIN DEATH?

• Occurs when the brain and the brain stem stop
  functioning
• Injuries causing brain death include
• Drowning, trauma to the head from an accident,
  ruptured blood vessels in the brain
• Cardiac death is different from brain death.
  Cardiac death happens when the heart and lungs
  stop functioning and people who die from cardiac
  death cannot donate their organs

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ORGAN DONATION ACT OF 1991

• Authorizing the legacy or donation of all or part
  of a human body after death for specified
  purposes.

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IS BRAIN DEATH THE SAME AS COMA OR VEGETATIVE
STATE?

• NO, a person in a coma or vegetative state still
  has some brain activity and therefore is not
  considered brain dead.

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HOW DOES ONE BECOME A CADAVER ORGAN DONOR?

• The prospective organ donor should tell to his
  family his wishes and in the event of his death,
  permission must be given by his family/next of
  kin
• He may also sign a donor card or express his
  intentions in his drivers license. Although
  these are both considered legal documents, his
  familys permission for donation must still be
  obtained

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WHO IS CONSIDERED HIS NEXT OF KIN?

• After brain death is determined, his family will
  be offered the option of organ donation. His next
  of kin will grant the permission for donation
• List of next of kin in ascending order (with the
  top most ranked highest)
• Spouse
• Adult son or daughter
• Either parent
• Adult brother or sister
• Grandparent
• Legal guardian
• Medical examiner

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HOW DOES HOPE LEARN OF POTENTIAL ORGAN DONORS?

• as soon as medical personnel in local hospitals
  identify a potential organ donor, they call a
  HOPE coordinator. The coordinator helps the
  hospital and family with the medical and legal
  aspects of the donation process

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HOW ARE ORGANS DISTRIBUTED TO PATIENTS WAITING
FOR ORGAN TRANSPLANTS?

• Every patient waiting for a cadaver organ
  transplant is registered with HOPE which manages
  a network to match organ donors with waiting
  transplant recipients
• When a family gives permission for organ
  donation, HOPE gets the medical information about
  the donor to facilitate matching to prospective
  recipients
• Matching is based on medical criteria

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CAN HUMAN ORGANS BE BOUGHT OR SOLD?

• NO. In order to manage and regulate the act of
  organ donation as well as the conduct of
  non-related kidney transplantation, DOH issued
  the Administrative Order No. 124, s 2002
• National Policy on Kidney Transplantation from
  Living Non-Related Donors (LNRDs)

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National Policy on Kidney Transplantation from
Living Non-Related Donors (LNRDs)

• This order sets the guidelines and ethical
  principles in conducting kidney transplantation
  from LNRDs, which will stop profiteering, remove
  brokers and make sure donations, are not an
  organized commercial effort.