ORGAN AND TISSUE DONATION FOR TRANSPLANTATION

HOW THE
PROCESS WORKS
 

How can I become a donor?

To become an organ or tissue donor, you need to have a conversation with your family,
friends and loved ones, because your family will be asked to confirm your wishes upon
your death.

Anyone can donate organs and tissue. A person’s age and medical history will be
considered as part of the donation process, but people shouldn’t exclude themselves by
thinking they are too young, too old or not healthy enough.

What organs and tissues can be donated?

Transplants using deceased donor organs are well established for kidneys, liver, heart,
lungs and pancreas.

Eye and tissue transplants are available in Australia for corneas, sclera, heart valves,
musculoskeletal tissue (bone, tendon and ligaments) and skin.

When can organ and tissue donation occur?

The way in which a person dies determines whether they are able to donate organs and/or
tissue. Organ and tissue donation can occur in the case of brain death or cardiac death.

A person may donate organs where they have been declared ‘brain dead’ in an intensive
care unit in hospital. The majority of organ donations occur after brain death. Less than
one per cent of all people who die in hospital each year die in this way.

Organ donation may also be possible after a person’s heart has stopped beating, referred
to as ‘cardiac death’, but this is less common.

Many more people are able to donate tissue for transplant. Unlike organs, tissue may be
stored for a period of time and successful tissue donation and transplants can take place
in more varied circumstances than is possible with organ donation.

When is the issue of donation first raised with my family?

 
A specially trained clinician will approach the family about the possibility of donation once
medical assessment indicates that there is no chance of recovery. This may occur in the
emergency department or in the intensive care unit.

Australian protocols ensure that a decision on donation is not made and organ donation
processes do not begin until a patient has been certified as brain dead.

A series of tests is carried out by two independent and appropriately qualified senior
clinicians to establish brain death of a patient. These doctors are not involved in the organ
and/or tissue donation process.
 

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Who makes the final decision about donation?

 
Your family will ultimately give final consent, which is why it is important that you have
made your wishes clear to them. You can use these conversations to find out what your
family, friends and loved ones want too.
 
What happens next?
 
If your family confirms your wishes to donate, and if you want to be a donor upon your
death, your family will then be asked to complete a form giving formal consent to the
organ and/or tissue donation.

Once your family has agreed in writing to donation, a dedicated and trained donor
coordinator will work with specialist teams to help assess your medical suitability. They
will also keep your family up to date with what is happening and support them.

All potential donors are screened through a review of medical records and completion of a
questionnaire by your family.

If you meet initial suitability criteria, you would then undergo a thorough medical testing
process to ensure that transplant recipients receive as safe a transplant as possible.
 
How do they decide who benefits from my organs and/or tissues?

Screening information from the rigorous testing phase is used to identify potential organ
or tissue recipients from waiting lists.

Allocation of organs is a complex process that depends on a range of factors including

medical need, urgency and capacity of the recipient to benefit from a transplant.
 
Will it be my original doctors and nurses who oversee the donation?
 
Organ retrieval is generally undertaken by organ-specific transplant teams.

The transplant units accepting the donated organs are largely responsible for arranging
the retrieval procedure: either using a surgical team from their hospital or by
arrangement with a suitably qualified surgeon from elsewhere. The organ transplant team
will attend the hospital where the donor is located to retrieve the organ and then return to
the transplant unit where it is based to perform the transplant.

Meanwhile, the donor coordinator organises the operating theatre for the retrieval,
ensures that the strict legal, ethical and procedural guidelines are followed, and completes
the required documentation.

 
 

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What organs and/or tissue are retrieved and what happens during the operation?
 
Surgeons will only retrieve organs and/or tissues that the family has agreed to, based on
your wishes, and that are suitable for transplant and for which a suitable match has been
found.

The removal of organs and tissue for donation is no different to any other surgical operation
and is performed by highly skilled health professionals. Donors are always treated with
respect and dignity.
 
How long does it take for the organs and tissues to reach their intended
recipient(s)?
 
There is a limited timeframe, particularly for organs, to be transplanted into the recipient:

• hearts and lungs must be transplanted within approximately six hours after being
retrieved from the donor;

• livers and pancreas must be transplanted within 12 hours; and

• kidneys must be transplanted within 24 hours.

 
Many more people are able to donate tissue for transplant. Following processing, tissues
such as heart valves, skin and musculoskeletal tissue can be stored in defined conditions for
up to five years before being used for transplantation.

Will my family get updates on how the transplant procedures went?

The donor coordinator will get in touch with your family to let them know which organs
and/or tissues were transplanted, how the transplants went, and which tissue (if any) has
been stored for later use. The coordinator will stay in touch with your family, ensuring that
they receive the bereavement and any other ongoing support they may need.

 
 

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