2. Title of presentation Introduction into Organ and Tissue Donation. Christine Ross DSN CNC.

3. Introduction to Organ and Tissue Donation Organ Donation is a life-saving and life-changing medical process where organs & tissues are removed from a donor & transplanted into someone who is ill or dying from organ failure. There are 74 hospitals in Australia that have dedicated donation specialist staff and many more hospitals that contribute to Organ and Tissue donation services. The DonateLife Network includes OTA staff, DonateLife agency staff and DonateLife hospital-based staff who work with a broad range of colleagues in the health system, including eye and tissue banks, to implement the Australian Government’s national reform agenda to increase organ, eye and tissue donation for transplantation.

4. Who benefits from your gift of life People need an organ transplant when their own organs are failing. Organ failure can happen to people of any age, including babies, children and adults. One organ and tissue donor can save or enhance the lives of 10 or more people. Despite the hundreds of life-saving organ transplant operations performed in Australia each year, Australia meets only one third of its transplant demand. Almost anyone can donate organs and tissues. Age, health and lifestyle do not automatically exclude an individual from being a donor. The determining factors are where and how the donor dies and the condition of the organs and tissues. There are only a few medical conditions that may prevent someone from being a donor.

5. The Australian Situation Australia is a world leader in successful transplantation outcomes Our organ and tissue donation rates have remained relatively static over the past decade

6. National Reform Agenda Initiated to: Improve the donation process Remove barriers to donation through increased clinical capacity and capability in hospitals Drive and co-ordinate a nationally consistent program Build a national eye and tissue network Optimize organ and tissue allocation Build a National Information System

7. NSW Organ & Tissue Donation 7

8. Organ & Tissue Donation Services DonateLife NSW NSW Tissue Banks

9. Why think about Organ Donation now? Fact: In your life time - you are 10 times more likely to need a transplant than you are to be in the position to be a donor

10. In addition…. 90% Australians support organ & tissue donation But… 45% of Australians don’t discuss their donation wishes with their family Which results… Half of families refuse donation when asked

11. Our Message Discover the facts about organ and tissue donation Discover Make an informed choice and Decide about becoming an organ donor Decide Discuss your decision with those close to you and know each other’s wishes Discuss

12. Kidney 1070 Liver111 Heart 192 Lungs149 Pancreas 39 Intestine1 Stomach1 TOTAL 1563 Australian Waiting List as of 1st August 2012

13. 29 8 78 88 12 92 15 32 Australian Organ Donation Data 2012 354 Donors

14. Australia 2012 1052 People who received a life changing transplant 1099 103 29 234 105 266 275 55 ACT 32 Solid organs retrieved and transplanted

15. 2012 Statistics Australia:  354 Donors  1099 Organs transplanted  73 intended donors  75 of the 354 were Donation after Cardiac Death (DCD -22%)  15 Donors per million

18. 1983 NSW Human Tissue Act History: The Donation ‘Timeline’ Christiaan Barnard – 1 st Human Heart Tx 1967 1966 Pancreas Tx 1956 Kidney Tx 1986 Double Lung Tx 1985 Liver, Kidney Tx 1987 Kidney & Pancreas Tx 1990 Single Lung Tx 2007 NSW DCD Guidelines 1979 Netherlands Australian Transplant Programs Transplant & Donor Coordinator Appointments Non-Heart Beating Donation Donation After Brain Death (DBD) DBD & Donation After Cardiac Death (DCD) 1983 UK, Sweden, Australia 1981 USA 1984 Heart Tx 1963 Lungs Tx

19. Pathways to Organ Donation Donation after Brain Death (BD) Donation after Cardiac Death (DCD ) Live donation – kidneys and liver segment Tissue Donation – heart valves, eyes and musculoskeletal tissue

20. What is a legal definition of death? Irreversible cessation of all function of the person’s brain, or Irreversible cessation of circulation of blood in the person’s body. Human Tissue Act 1983 Brain death Cardiac death

21. Legislation NSW Human Tissue Act - 1983 The Coroner’s Act - 2009

22. How does Brain Death occur Severe cerebral injury Brain swelling Intracranial hypertension Reduced cerebral blood flow Cerebral ischemia As this cycle continues, cerebral blood flow declines to a point at which it ceases altogether and whole brain death occurs

23. What can be donated? HEART ( heart valves only- if Donation after Cardiac Death) LUNGS LIVER KIDNEYS PANCREAS EYES HEART VALVES BONES & TENDONS

24. Obtaining Consent Phased out from Nov 2012 NOK Coroners AODR

25. Common Questions Will doctors work to save my life if they know I’m a donor? Am I too old/too young or not healthy enough to donate? Can my family override my decision? Will donation disfigure my body? Will it cost my family money to donate organs & tissues? Will donation delay the funeral arrangements?

26. What About Religion ??

27. DONATION PROCESS

28. Why are Organ Donation rates so low? Brain Death only accounts for around 1.5% of hospital deaths ~ 50% decline rate Improved Car/Road design Improved Health Care Delivery Falls prevention programs Workplace safety standards

29. 1800 777 203 www.medicareaustralia.gov.au  Tell your family!   Tell your friends!   Australian Organ Donor Register How do you make your wishes known?

30. ‘Next Step Program’ Outcome of donation & support by phone Resources - ‘In Reflection’ booklet Access to Counseling Annual Service of Remembrance and reflection Correspondence from recipients Cards on the 1st and 2nd Anniversary

31. Tissue recipients - tendons The generosity of her donor and their family have changed Morgan’s outlook on life - “I never really thought about organ donation before… I may not have received a heart or a lung or something that is totally life-changing, but I have received…(a patella tendon graft)… something that is helping me achieve my goals” Tina Morgan, Australian Tae kwon doe athlete, Sydney Morning Herald, Sept 24, 2007 Winning her second Olympic gold medal Alisa Camplin thanked the organ donor whose generosity allowed doctors to repair her right knee so she could compete -“I am a registered organ donor and I am the lucky recipient of one …thank you, thank you …” Alisa Camplin, Australian Aerial ski jumping athlete, The Age, January 27, 2004