Question

1. Please explain how human organ donation and allocation work in this country. What systems do we have in place? Consider this from the perspective of the organ donor and the recipient of the donated organ. 2. Hypothetical: You are in immediate need of a heart valve replacement. Your cardiothoracic surgeon presents you with three options for the replacement: a) a human tissue valve; b) a bovine or porcine tissue valve; or c) a mechanical valve. Option a) means waiting on a list until human donor tissue becomes available. Options b) and c) would allow you to proceed immediately; however, option b) involves the transplantation of animal tissue, i.e. xenotransplantation, and option c) would put you at greater risk of developing blood clots, requiring you to take blood thinners for the rest of your life. Do you elect to go with a), b), or c) and why? Please address all three options in your answer (for example, say you selected a), please explain not only why you selected a), but also why you did NOT select b) or c)).

Answer 1

Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.

Donation may be for research or, more commonly, healthy transplantable organs and tissues may be donated to be transplanted into another person.

Common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Some organs and tissues can be donated by living donors, such as a kidney or part of the liver, part of the pancreas, part of the lungs or part of the intestines, but most donations occur after the donor has died.

In 2017 Spain had the highest donor rate in the world at 46.9 per million people, followed by Portugal (34.0 per million), Belgium (33.6 per million), Croatia (33.0 per million) and the US (32.0 per million).

As of February 2, 2019, there were 120,000 people waiting for life-saving organ transplants in the US.Of these, 74,897 people were active candidates waiting for a donor.While views of organ donation are positive, there is a large gap between the numbers of registered donors compared to those awaiting organ donations on a global level.

Organ donors are usually dead at the time of donation, but may be living. For living donors, organ donation typically involves extensive testing before the donation, including psychological evaluation to determine whether the would-be donor understands and consents to the donation. On the day of the donation, the donor and the recipient arrive at the hospital, just like they would for any other major surgery. For dead donors, the process begins with verifying that the person is undoubtedly deceased, determining whether any organs could be donated, and obtaining consent for the donation of any usable organs. Normally, nothing is done until the person has already died, although if death is inevitable, it is possible to check for consent and to do some simple medical tests shortly beforehand, to help find a matching recipient. The verification of death is normally done by a neurologist (a physician specializing in brain function) that is not involved in the previous attempts to save the patient's life. This physician has nothing to do with the transplantation process. Verification of death is often done multiple times, to prevent doctors from overlooking any remaining sign of life, however small.After death, the hospital may keep the body on a mechanical ventilator and use other methods to keep the organs in good condition.Donors and their families are not charged for any expenses related to the donation.

More than 120,000 people in the U.S. are waiting to receive a life-giving organ transplant. We simply don't have enough donated organs to transplant everyone in need, so we balance factors of:

justice (fair consideration of candidates' circumstances and medical needs), and

medical utility (trying to increase the number of transplants performed and the length of time patients and organs survive).

Many factors used to match organs with patients in need are the same for all organs, but the system must accommodate some unique differences for each organ.