Q: Who is a deceased donor?
A: This is an individual whose tissues or organs are donated after his or her death.
Q: What types of diseased donors are there?
A: Donations come from two sources:
1. Patients who have suffered brain death. They are also known as heart beating donors or donor after brain death.
2. Patients whose hearts have irreversibly stopped beating i.e. cardiac death. They are also known as non heart beating donors or donor after cardiac death.
Q: Who are heart beating donors?
A:
· These are donations from people who have suffered an injury such as a fall, motor vehicle accident or a stroke.
· The determination of irreversibility, as well as the determination that all brain function is not present, is only made after repeated, confirmatory testing over a prolonged period of time.
· Only then are the organs from a deceased donor retrieved by a surgical team.
Q: Who are non-heart beating donors?
A:
· These are transplant kidneys from people whose hearts have stopped beating. These donors – called non-heart-beating donors – are people who have died very suddenly, usually from a heart attack.
· Their hearts have stopped beating and they are brain dead. They have not been put on a life-support machine.
· Kidneys from non-heart-beating donors often do not work immediately after transplantation and are not quite as good as those from heart-beating donors. However, advanced technology of organ perfusion and preservation has resulted in improved outcome.
Q: Can the kidneys or any other organs just be removed from the deceased?
A: No. Any organ for transplant has to be removed with the permission of the donor’s family.
Q: What are the events that lead to being a deceased donor?
A:
1. The kidneys can only be removed after the patients have been diagnosed ‘brain dead’. This means that the part of the brain called the brainstem, which controls breathing, has stopped working permanently and patient is only being supported on a life support machine.
2. When the brainstem is dead, there is a permanent loss of consciousness and all feelings.
3. If the donor is on a ventilator (life support) machine, they are taken to theatre for donation while the ventilator is working and their heart is beating. For this reason, these donors are sometimes called heart-beating donors. Even though the heart is still beating, they would not breathe if they were not on a life support machine. Their brain is dead, and they have no chance of recovery, and indeed they have already been certified as legally dead by doctors from the intensive care unit.
4. Although brain-dead (or "heart-beating") donors are considered dead, the donor's heart continues to pump and maintain the circulation. This makes it possible for surgeons to start operating while the organs are still being perfused.
5. Treatment is discontinued (mechanical ventilation is shut off) then a time of death is pronounced. The patient is then rushed to the operating room where the organs are recovered. Storage solution is flushed through the organs. Since the blood is no longer being circulated, coagulation must be prevented with large amounts of anti-coagulation agents such as heparin.
6. Several ethical and procedural guidelines must be followed; most importantly, the organ recovery team should not participate in the patient's care in any manner until after death has been declared.
Q: Is diseased donation available in Nigeria?
A: No. In Nigeria, the main sources of donors are living and are genetically or emotionally related and altruistic in nature. Deceased donors are the main source of kidney donors in UK and America
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