800-DONORS-7 core.org Advisory Committee on Organ Transplantation Informed Authorization for...

800-DONORS-7 • core.org

Advisory Committee on Organ Transplantation Informed Authorization for

Vascularized Composite AllograftKurt Shutterly

Chief Operating Officer


Legal Aspects of Donation

• Authorization– Family Authorization– First Person Authorization

• Pronouncement of Death• Medical Examiner/Coroner Communication


Authorization Requirements for Organ Donation

• Brain Death and Cardiac Death• When to Approach:

– Brain Death Pronouncement– Family Decides to Withdraw Support

• DNR/CMO Patient

– Unstable Potential Donor


First Person Authorization

• Drivers License• Living Will• Donor Card• Authorization Document


Matching the Donor and Recipient for VCA

• Selection Criteria from TX Center• Screening• Identification Process• Donor/Recipient Match


Providing the Opportunity for Vascularized Composite Allograft (VCA)

• The “Request for the Gift”– When to approach?– Recipient information– Authorization required

• First person authorization


Informed Authorization

• No Additional Costs• Funeral Home Viewing

– Reconstruction– Prosthesis

• Recipient Information• Media• Donor Family Follow Up


Recovery Process

• Coordination• Preparation of Hand and Forearm• Perfusion• Retrieval• Transportation• Reconstruction• Follow Up


An Organ Procurement Organization’s Experience with VCA

• Donor Families support VCA• Five hand Transplants in 18 months

– Ability to do much more

• National List needed for Allocation• Reconstruction and Funeral Home Relations


Post Donor Review

• It’s all about the “Gift”• Funeral Home • OR Staff• Donor Hospital • Transplant Surgeons


Family Meeting


CAMC General Feedback

CRNAI was thrilled to take part in this particular CORE case. This is the ultimate gift in my opinion, and I want you and your organization to know that you always have my support.

Being able to take part in that groundbreaking case was wonderful and overwhelming.

Donor Advisory Group Member

• I was very excited and thrilled about this unique situation since we had been doing kidney transplants and organ donation for over 20 years

Hospital Chaplain

I acknowledged her generous gift of life that she shared with another in need and told the mother that this was the first gift of this kind that we had ever had donated from CAMC.


Transplanted

J.A.,female, 27 yearsOccupation – Student/MotherCause of Amputation: ischemic gangrene after Nota virus infection 2004Amputation: both lower and upper limbs Amputation level: distal wrist and fingersTransplant Side: Right wrist


Post Transplant


Transplanted

S.A.,female, 33 years, RHDOccupation – Customer Service AgentCause of Amputation: ischemic gangrene after Meningococcal septicemia 2003Amputation: Both upper and lower limbs Amputation level: R & L distal forearmTransplant Side: Bilateral forearm


One Month Post Transplant


THANK YOU!

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800-DONORS-7 core.org Advisory Committee on Organ Transplantation Informed Authorization for...

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