How do families choose between living and deceased donor transplants?
We encourage living donors always. Living donor transplant is the best option for a child. We know that it typically works better faster and lasts longer. However, if the family has exhausted all options for a living donor, or for whatever reason they don’t have anyone that’s able to be a living donor, deceased donor transplant is an excellent alternative.
Rachel Blumenthal, RN, BSN, CNN, Transplant Coordinator, Kidney Transplant Program
What does the process of living donor transplant involve?
Rachel: The family puts together a list of potential donors, and we do something called tissue typing, which is a blood test to know how well those people match against the recipient, including their blood type and antibodies. Once the tissue typing is done, it takes two weeks to get the results back, and then we discuss the results with the family. Sometimes there is no best match, but we talk about it and then we give the family the option of one person to go forward first. That one person goes forward with the donor evaluation, which is a series of tests, blood tests and urine tests and meeting with their primary care doctor.
Courtney: All the results are faxed to us. We make sure everything’s there, and then we send them over to the Brigham to the independent donor advocate at Brigham and Women’s Hospital.
Rachel: They decide if the donor can go forward and it is non-negotiable if they do not feel the donor is a suitable donor.
Courtney: The donor team could say no for a number of different reasons. You never want to put the donor at risk. You want to have the best donor for the patient, and you also want the donor to be able to live a very healthy, normal lifestyle after transplant. If the donor is ruled out, we ask the family go back to the list of donors, and we start the next evaluation. And it happens: about 1/3 of our donors don’t pass the evaluation.
Courtney Loper, RN, MSN, CPNP and Rachel Blumenthal, RN, BSN, CNN, Transplant Coordinators, Kidney Transplant Program
How do people register to be organ donors?
People can sign up to be donors on their license, through UNOS.org, or donatelife.org. They can register in their state to be an organ donor. The biggest thing, though, is talking to your family about it and letting them know your decision. Even if you put it on your license, family ultimately makes the decision, so one of the important things is letting your family know.
John Kueven, MSHA, MBA, RN, Administrator of the PTC
How can transplant families acknowledge their donors’ gift?
I think families facing transplantation are a little bit unique in that they have to also think about donors that have died and the families have made these tremendous gifts. We try to teach the kids and the families that not only are they obviously fortunate to have this gift, but they have a special responsibility as shepherds of this gift to take care of these organs and remember the donor families. We have a mechanism in place for them to anonymously be in contact with donor families, express their thoughts, and so forth, so we like to make sure that the donors are recognized in the process as well.
Maureen Jonas, MD, Medical Director, Liver Transplant Program