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TISSUE DONATION PROCESS
The needs and wishes of the patient’s family are always kept in focus by the medical team, by the LifeShare staff members, social workers and clergy. The donation decision is made in the midst of enormous personal loss. Sensitivity, the willingness to listen, and the ability to explain procedures in common terms can make tissue donation an easier decision for families to make. It is a compassionate team effort.
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Step One
Referral call is made to LifeShare after a patient death A referral call is placed to LifeShare after cardiac time of death is determined in order to obtain basic patient demographics and cause of death. An evaluation for tissue donation is done at that time. *Remember* If your patient was deferred for organ donation, another call MUST still be made within 1 hour of cardiac time of death. |
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Step Two
Evaluation During your call to notify LifeShare of the patient’s death, there is a series of questions that are asked to determine eligibility. There are two screenings for this. The first set of questions is to include basic screening and is required for every referral in the LifeShare EMR. If the screening doesn’t identify any rule outs for tissue eligibility, then the coordinator will start secondary screening questions. These additional questions include items like chest x-rays, medication administration, patient temperature, etc. Example of questions is included at end of this section. |
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Step Three
Donation Conversation by telephone and Authorization If the patient is determined to be eligible, the LifeShare Donation Services Coordinator will call the family to talk about donation. During this time, the family can decline or support their loved one to be a tissue donor. They will complete authorization on a recorded line and answer a questionnaire of social and medical history of their loved one. It is not necessary for you to inform the family of LifeShare’s call to them. The request for donation should only be brought up by LifeShare staff as it can be a sensitive conversation in which extensive training is completed to understand how to request and explain what the patient is eligible for. The patient may or may not be registered to donate as well, and this is something that is explained in the donation conversation to the family. The family is informed of the many factors that may impact the timing of the funeral, the timing of recovery procedure and/or autopsy that needs to be completed. |
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Step Four
Funeral Home Notified The funeral home will be notified after authorization is obtained and funeral home information is provided by the family to the donation coordinator. Recovery timelines can vary depending on the number of tissues that are expected to be recovered. LifeShare will work with the funeral directors handling the funeral arrangement for the donor family as soon as details of the anticipated recovery are known. |
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Step Five
Recovery of Tissue The tissue recovery is performed within 24 hours of death and in an environment where a sterile field can be maintained. This is always performed at the LifeShare Tissue Recovery surgical suite. |
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Step Six
Enhancing More Lives Tissue recovered ultimately enhances lives to patients in need such as restoring mobility and sight. Through tissue donation, more than 75 lives can be enhanced with one patient’s gift. |
Tissue and Eye Screening Information Sheet
Please call within ONE HOUR of asystole
1-800-241-4483
Please call within ONE HOUR of asystole
1-800-241-4483
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Basic Patient Information
Name, DOB Height & Weight Sex and Race Medical Record Number Clinical Information Reason for admission/ circumstances surrounding death Past Medical History High risk behavior: Evidence of drug abuse or jail time Time of death or last time known alive (if available) Further Clinical Information Patient mobility and skin condition Recent diagnosis’s • WBC’s (Several from stay) • Procalcitonin and Lactic Acid • Temperatures (Several from Stay) • Culture reports (Blood, sputum, wound, etc.) • CXR’s (Impression from most recent) IV fluids/crystalloids given in the last hour Colloids/Blood products given in the last 48 hours • Any significant blood loss? Antibiotics given (dates started and stopped) Home Medication List EMS Service that transported patient if < 48 hours Patient Disposition and Family Information Medical Examiner Case • Reported? • Accepted? Funeral Home Information • Name of Funeral Home? • Have they been called for transport? Next of Kin Information • Name • Phone Number |
TYPES OF TISSUES REMOVED AND COMMON USES:
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Skin – Dermis
Full thickness skin tissue is taken from the back, lower abdomen and circumferential legs. Uses: Helps to protect burn victims from infection with skin grafts or women who have had mastectomies and need reconstructive surgery. Skin, also known as dermis, is the type of tissue that LIfeShare recovers the most of. Full thickness skin tissue is procured from the back, lower abdomen and bilateral circumferential upper legs. Other uses are to help protect burn victims from infections and help with creating closures as well as it is used in several other reconstructive applications due to trauma or cancers. |
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Musculoskeletal
Includes connective tissues such as ligaments, tendons, and supporting structures. Bones include upper and lower leg bones, upper arm bones (only humerus) and sometimes ribs with costal cartilage. All connective tissue is procured from the lower extremities. Uses: Restores mobility, promotes healing and prevents amputation of limbs. Common surgeries using allografts - ACL repair, spinal fusion, bone reconstructions, joint revisions. |
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Cardiovascular
Heart Valves- Aorta, pulmonary arteries and veins Uses: Infants with congenital heart defects or adults with heart valve issues. Veins- Saphenous, femoral, and aortoiliac Uses: Helps to restore circulation and prevent amputation of limbs. |
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Corneas
Corneas are about the size of a contact lens and do not affect the way the eyes look. Uses: To restore sight and /or can prevent blindness of up to two people. *Common eye issues such as bad vision, macular degeneration and cataracts are approved for eye donation. |
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Nerves
Includes nerves from the upper and lower extremities and is recovered alongside musculoskeletal. Nerves from the arm include the musculocutaneous, median, ulnar and radial. Nerves from the leg include the femoral nerve bundle and branches, superficial fibular, deep fibular, common fibular, lateral cutaneous sural, tibial nerve, sural and the sciatic. Uses: Nerves can be used to repair traumatic upper and lower extremity injuries resulting in the loss of nerve function including numbness, pain or loss of motor function. Additionally, cancer patients undergoing tumor removal can benefit from nerve transplant. |
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Birth Tissue
The placenta serves as a baby’s lifeline while in utero, providing nutrients and oxygen until birth. Once born, the placenta serves no further biological purpose for the baby, and these tissues are typically discarded as medical waste. After delivery, the placenta is still rich in matrix proteins (e.g., collagen) and growth factors (e.g., cytokines). These properties make birth tissue an ideal therapeutic tool primarily for wound care, but also among other surgical treatments. Application of birth tissue to acute and chronic wounds can expedite healing, reduce pain for recipients, and diminish scar formation. Birth tissue is so delicate it can be used for direct applications for eyes and spinal cord injuries to promote healing. |
KEY HIGHLIGHTS
• Call on EVERY death
• Call within ONE HOUR of patient's death
• DO NOT call the funeral home until after speaking with LifeShare Coordinator
• DO NOT initiate any donation conversation with family
• ME case DOES NOT rule out donation
• The bedside RN is the critical starting point for every life saved through donation
• Refer every patient death, regardless of age or disease process
• Late and/or missed referrals may impact or take away the opportunity to their family to donate.
• Patient's donor registration status will be determined by LifeShare
*This criteria meets the Center for Medicare & Medicaid Services regulations pertaining to organ and tissue donation.
• Call within ONE HOUR of patient's death
• DO NOT call the funeral home until after speaking with LifeShare Coordinator
• DO NOT initiate any donation conversation with family
• ME case DOES NOT rule out donation
• The bedside RN is the critical starting point for every life saved through donation
• Refer every patient death, regardless of age or disease process
• Late and/or missed referrals may impact or take away the opportunity to their family to donate.
• Patient's donor registration status will be determined by LifeShare
*This criteria meets the Center for Medicare & Medicaid Services regulations pertaining to organ and tissue donation.
