For some patients who are critically ill, the only alternative treatment is organ transplantation. The name of each patient needing an organ transplant is added to the national computerized waiting list by a physician at a one of the nine transplant centers in the Greater New York metropolitan area. In certain circumstances, a patient may be listed at more than one transplant center (a so-called "multiple-listing"), but in order for that to happen, the candidate needs to be able to reach all of the transplant centers quickly should an organ become available. This is due to the fact that once organs are recovered from deceased donors, they have to be transplanted within a certain time limit. For instance, hearts have to be transplanted within four hours after recovery; livers between 12 and 18 hours; and kidneys within 24-48 hours.
The waiting list for organs 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. The 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.
When a person becomes an organ donor, specific information about that person, 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 of the New York Organ Donor Network 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.
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.
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.
At that point, organ transplantation takes place, and another life is saved.
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