CHAPTER 21 Organ and tissue transplantation
Classification
This depends on the relationship between donor and recipient.
Organ and tissue donors
Organs and tissues may be obtained from:
Deceased donors
Donation after brain death (DBD)
General criteria
Brainstem dead with intact circulation |
Cause of death: |
Exclusions: |
Absolute |
Relative |
Obtaining permission for deceased organ donation
Donation after cardiac death (DCD)
This type of organ donation applies to renal transplantation and liver transplantation only but tissues such as heart valves, corneas, bone, etc. can also be removed from this type of donor. The distinction between a DBD and DCD donor lies in the mode of death. DBD donors usually die from an intracranial catastrophe (→ Table 21.1), the mode of death being classified as ‘brainstem death’. In DCD donors, the patient dies from a cardiorespiratory arrest, their death being classified as a ‘cardiac death’. After death, kidneys are viable for around 30 min (maximum of 45 min in young donors).
Living donors
Categories of living donation established under the Act are:
Independent assessors
Work-up for a living donor
For a genetically related donor, there are three potential histocompatibility matches:
The following sequence is undertaken: