Organ and tissue donation involves a complex series of events requiring the teamwork and
cooperation of the physician(s) and nurse(s) caring for the potential donor, other hospital staff, the
organ transplant coordinator(s), the donor's family and the transplant surgeon(s). The entire donation
process may take anywhere from a few hours to a day or two depending on the individual circumstances.
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Donor Referral:
At or near the time of a patient's death, a physician, nurse,
or other designated representative from the hospital contacts the New York Organ Donor Network at 1-800-GIFT-4-NY
(1-800-443-8469). They provide confidential information to determine if the patient is a potential donor.
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Medical Evaluation:
A transplant coordinator travels to the hospital to evaluate each potential donor and to determine the
medical suitability of each organ. The transplant coordinator obtains detailed medical information about
the patient's current medical condition as well as any past medical history. After obtaining consent, the
transplant coordinator also conducts a detailed interview with the next of kin and completes a medical and
social history questionnaire about the donor. Many of these questions are similar to those asked when
someone donates blood.
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Declaration of Death
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Consent for Organ Donation is Obtained:
The transplant coordinator or family services coordinator meets with the potential donor's next of kin, or other authorized party, to offer the opportunity for donation. This conversation is carefully timed and only takes place after the next of kin is given time to understand their loved one is brain dead. Detailed information is provided about the organ donation process including which organs and/or tissues may be donated, how and when the recovery will take place, testing that will be required to determine the medical suitability of the donations, and how the organs and/or tissues will be distributed to the patients needing transplants. After making the decision to donate, the next of kin will be asked to sign a consent form documenting which organs and/or tissues they wish to donate.
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Medical Examiner/Coroner:
Prior to the recovery of any organs or tissues, the transplant coordinator must also contact the appropriate
county Medical Examiner or coroner if the death is under their jurisdiction.
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Organ Allocation and Recipient Identification:
Each patient awaiting an organ transplant is listed on a national computerized waiting list that is maintained by
the United Network for Organ Sharing (UNOS) in Richmond, VA. This registry contains detailed information about
each patient including their blood type, degree of medical urgency and other data important for matching donors
to recipients. This registry changes constantly as new patients are added to the list, and as other patients
either receive a transplant, die waiting, or due to a change in medical condition, are removed from the list.
Specific information about each donor, including his or her blood type and body size, are entered into the national
computer system. An individualized list is generated for each donor that identifies patients who match for those
particular organs. There is a different list generated for each and every donor. Each available organ is allocated
according to medical urgency, degree of match to the donor and time waiting.
The transplant coordinator then contacts the transplant center where each potential recipient is waiting and
provides detailed, confidential information about the donor. The transplant surgeon always makes the final
decision about whether or not the donor and intended recipient is a good match.
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Organ Recovery Procedure:
The recovery of the organs is performed in the Operating Room where the donor is being cared for. The
transplant coordinator oversees the arrival and departure of the surgical recovery teams. The recovery
team consists of surgeons, nurses, the transplant coordinator and an organ preservation technician.
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Organ Preservation:
Just prior to being removed from the donor, each organ is flushed free of blood with a specially prepared
ice-cold preservation solution that contains electrolytes and nutrients. The organs are then placed in
sterile containers, packaged in wet ice, and transported to the recipient's transplant center.
It is important to transport the organs from the donor to each intended recipient as quickly as possible.
Hearts and lungs must be transplanted within approximately 4 hours after being removed from the donor.
Livers can be preserved between 12 - 18 hours; pancreas can be preserved 8 - 12 hours; intestines can be preserved
approximately 8 hours; kidneys can be preserved 24 - 48 hours.
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Donor Family Follow-up:
After the organ transplants have been completed, a letter is sent to the donor's family that includes
information about the outcome of the donations. Care is taken to preserve the identity and location of
the recipient(s), but general information is given about how they are doing after receiving their transplant.
Similar letters are also sent to the doctors and nurses who cared for the donor at the hospital.
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Costs:
All costs directly relating to the recovery of the organs, including laboratory tests, use of the operating room,
surgeon's fees, transportation, etc., are billed to the New York Organ Donor Network. The recipient's transplant
hospital then reimburses the Donor Network for the recovery costs. In turn, the transplant hospital is
reimbursed by the recipient's insurance company or through Medicare.
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