Organ & Tissue Recovery
- About UNYTS' Organ and Tissue Services
- The Referral & Donation Process
- Preservation and Allocation / Distribution of Organs & Tissues
- Quality Assurance
About UNYTS' Organ and Tissue Services
The organ services department is responsible for clinical aspects of the donation process as well as professional education. The potential organ donor is evaluated and the family is given the option of donation by a recovery coordinator. The coordinator works extensively with the family and the hospital staff to ensure the wishes of the family are carried out. The heart, liver, kidneys, lungs, intestines, and pancreas are life saving organs that can be recovered from an organ donor.
UNYTS' tissue services department employs full time recovery coordinators as well as per diem technicians to perform the surgical recovery of tissue and eyes for transplantation and research. Some of these tissues include bone, heart for valves, saphenous and femoral veins, aortoiliac artery, skin and soft connective tissues, such as tendons. As more research is being done, the need for new tissues continues to grow and UNYTS provides the recovery staff with continuing education so that the wishes of the donor families may be maximized.
The Referral & Donation Process
As a result of Routine Referral legislation, all hospitals in the eight counties of Western New York are required to report all deaths and imminent deaths to UNYTS. Imminent death is defined as a death having occurred by means of brain death declaration, or a death that is going to occur in the immediate future. In both cases the patient must have suffered a severe neurological injury requiring the patient be maintained on mechanical ventilation support in order to be a candidate for organ donation. After receiving the referral, a UNYTS organ services coordinator is required to perform a medical/social screening of the potential organ donor. Once completed, the coordinator sits with family members of the potential organ donor to discuss option of donation.
When a hospital contacts UNYTS to refer a potential tissue donor (cardiac death has occurred), a coordinator in UNYTS' 24-hour communication center completes initial medical screening with the assistance of hospital personnel. Based on the screening, the coordinator contacts the next-of-kin to discuss what options for donation are available. If the family consents to donation, the coordinator asks more questions regarding the deceased’s medical and social history and records the conversation authorizing donation. When this is complete, the communication center staff coordinates efforts with the donor’s funeral home and makes arrangements for tissue procurement. UNYTS' tissue recovery coordinators then carry out the surgical recovery, working with hospital staff, medical examiners and funeral directors so that the process runs smoothly. After the recovery is complete, the funeral home can begin preparations.
Preservation and Allocation / Distribution of Organs & Tissues
The heart, liver, kidneys, lungs, pancreas, and intestine are all referred to as life saving solid organs. The organs are flushed with a cold preservation solution, Viaspan. Once recovered from the donor the organs are stored in Viaspan, packaged in sterile containers, and sent to the recipient hospital for transplantation. The preservation time (time from recovery to transplant) is different for each organ. Preservation time for the heart and lungs is 4 to 8 hours. It is 8 to 16 hours for the liver, pancreas, and intestine. The kidney’s preservation time is 24 to 48 hours. If the kidney is placed on a kidney pump, preservation time can be increase to 72 hours. Organs are allocated through a national waiting list. UNYTS is a member of UNOS, the organization designated by the federal government to maintain the national waiting list.
The most commonly transplanted portion of the eye is the cornea. The cornea is the dome shaped clear area over the colored part of the eye. It must be transplanted to a recipient within ten days of the donation. The sclera (the white part of the eye) can be transplanted up to one year after the donation. In some cases donated eyes and corneas are frozen for storage. This allows surgeons to transplant the tissue up to one year later. UNYTS is accredited by the Eye Bank Association of America (EBAA), a national organization that sets standards for eye donor screening, recovery and distribution. As a result of the generosity of the people of Western New York, UNYTS exports approximately 60% of the corneas that are recovered here. When there are corneas that need to be matched with a recipient, a UNYTS coordinator works closely with surgeons to meet the needs of the local community. Once this is accomplished and there are additional corneas, the UNYTS coordinator searches for a recipient throughout the state, the country and even the world. UNYTS is proud to say that it has been able to help provide the gift of sight to the local community as well as to a number of recipients in Europe, Taiwan, and even Malaysia.
The bone and some soft connective tissue is sent to a for profit company named Regeneration Technologies, Inc. (RTI) located in Alachua, Florida for processing. The bone is fashioned into many different sized and shaped grafts and is either freeze dried or frozen. This enables the tissue to be used up to several years after the donation so that just the right graft is used in each tissue transplant. The cardiovascular tissue is sent to a for profit company named Cryolife, Inc, in Kennesaw, Georgia. These tissues are cryopreserved which also allows the tissue to be used up to several years after the donation. UNYTS works very closely with its tissue processing companies to ensure that local surgeons can implant bone and other tissue from Western New York donors. As with cornea donation, once the local need is met the remaining tissue grafts will be used to help individuals throughout the country.
Quality Assurance
All organs and tissues recovered for transplantation undergo a very thorough screening process. While in the hospital, the potential organ donor’s medical record is reviewed for information regarding current hospitalization, medical history, and social history. A second medical/social history is then obtained, in the form of an interview, from the family and any other individuals that may have knowledge of the potential donor’s current or past medical/social status. A team comprised of the director of organ recovery services, the medical director of UNYTS, and local transplant physicians then reviews this information. If the potential donor is found to be suitable, the information is then passed on to the potential recipient’s physician. A report of all donors and potential donors is reviewed quarterly by UNYTS’ Quality Assurance Committee.
UNYTS is regulated by several different organizations. Among them are the Food and Drug Administration, the New York State Department of Health and the Eye Bank Association of America. UNYTS is periodically inspected by each of these agencies and has built in a system of checks and balances all the way from referral to distribution.
Donated tissue is handled very carefully to insure the greatest possible success in transplantation. It is first tested using stringent medical tests to determine usability. Then federal and state certified processing centers, working under the strictest standards, process the tissue for transplantation. Sometimes in the processing of tissue it may be made into a different form from its original form. For example, bone tissue is processed and reshaped into a wide variety of forms that become usable in many types of orthopedic surgeries.
For-profit and non-profit companies process donated tissue and make it available to doctors and transplant centers across the country. These processing companies also conduct research to develop new ways to process, recover, and use donated tissue.
Currently Upstate New York Transplant Services, Inc. has agreements with these organizations to process tissue donated by donor families in the Western new York area:
Regeneration Technologies, Inc. (RTI) processes bone tissue , connective tissue, and skin for musculoskeletal surgeries and burn treatment.
AlloSource Founded in 1994, AlloSource, of Centennial, Colorado is one of the nation’s largest non-profit providers of bone and soft tissue allografts for use in a host of medical treatments.