Title of presentation
Subtitle if needed
Having
the conversation….
Our National Launch
Introduction to
Organ and Tissue Donation
Leanne McEvoy
Donation Specialist Nursing Coordinator
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Acknowledgements
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Bettina Clark DSNC Austin Health
Dr Cameron Knott MDS Austin Health
Dr Sam Radford MDS Austin Health
Kate Tozer DSNC Austin Health
Dr Stephen Warrillow MDS Austin Health
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All ICU and Executive staff Austin Health
La Trobe University Melbourne
DonateLife Victoria
Aust. Organ and Tissue Authority
Gift of Life Institute USA
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Overview
 Organ and tissue donation
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What does it mean?
Why is it important?
Types of organ and tissues that can be donated
Who can be a donor?
 The Australian situation
 Austin ICU referral process
 Raising donation with families
 Key messages
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Austin Health
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Altruistic gift
Altruism = feelings and behaviour that show a desire to help other
people
Altruism involves doing for others without reward
Altruism or selflessness is the opposite of selfishness
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One organ and tissue donor can transform the
lives of 10 or more people.
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Organ donation is
life-saving
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Organ Donation
Heart 2 - 60yrs
Valves 3 months-60yrs
Lungs 2 - 75yrs
Intestine up
to 55yrs
Liver 1.5 - 75yrs
Kidneys 1 - 80yrs
Pancreas 10 - 50yrs
Islet cells 16 - 75yrs
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Corneas 2 - 80yrs
Sclera – no limit
Tissue Donation
Skin
teenager -70yrs
Bone & Tendon
18 - 65yrs
Heart Valves
3 months-60yrs
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Who can be an organ
donor?
 The opportunity for organ donation
occurs infrequently
 A person has to die in specific
circumstances for organ donation
to be possible
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Who can be an organ donor?
 Anyone from the age of 1 - 80 can
potentially become an organ & tissue donor
 No evidence of current malignant disease
 To become an organ donor you must:
 die in a hospital (usually in an Intensive Care Unit)
 attached to a ventilator
 Only 1% of hospital deaths
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Where do our donors come from?
 Spontaneous Intracranial haemorrhage
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subarachnoid or intracerebral haemorrhage
 Cerebral Oedema
 meningitis, acute hyperthermia/hypothermia
 Trauma
 motor vehicle accidents, gun shot wounds, falls
 Hypoxia injuries
 cardiac arrest, drowning, hanging, asthma
 Tumours
 primary brain stem tumour, astrocytomas
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The Australian Situation
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86% support organ and tissue donation
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Opt-in system
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58% of families consent for organ and tissue donation to proceed
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The most important thing that helps a family's decision is their knowing the
wishes of their loved ones
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44% do not know or are not sure of the donation wishes of their loved ones
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~ 1600 Australians are waiting for a life saving transplant
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Australia is a world leader in successful transplantation outcomes
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Organ and tissue donation rates were static for many years
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Australia has had a relatively low donation rate by international standards
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www.donatelife.gov.au/discover/facts-a-statistics
Australian Organ and
Tissue Authority - AOTA
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Patients meeting the Clinical Trigger criteria in ICU should be
considered for organ donation.
Contact the Medical Donation Specialist of Organ and Tissue
Donation via switch x90 or
Nurse Donation Specialist p2426 ext3424
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Our Aim…
Organ and Tissue Donation as routine part of end-of-life
care
Every potential donor is identified and every family is
properly informed and supported to make a decision
about donation
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Austin ICU model of donation
discussion
 Identify all potential donors
 Daily interdisciplinary huddle
 Modified the national trigger tool “E”
 Donation outcome is discussed with every
family, every time
 Medically suitable or not
 Registered on Australian organ donor register as ‘yes’ or ‘no’
 Request style
 Collaborative Request model implemented
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Collaborative Requesting Model
Brings together trained specialists to support the family in the
Family Donation Conversation (FDC)
Potential donor family
Requires specialist
support to understand
the death and the
opportunity of donation
Treating specialist team
Provides patient care and
family support to
understand the death or
inevitability of death
FDC
Donation specialist Requests donation and
provides information so the
family can make an
informed decision
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“Organ donation?
I can’t think about that
now…”
How would you respond?
Family Donation Conversation
Core Workshops
The Family Donation Core
Workshop covers:
• the reasons families say ‘yes’ to donation
• specific elements of family care and
communication
• key elements to informed decision making
• characteristics and benefits of a team approach
• effective communication until the family is ready
for the next steps
• strategies to support families and preserve
donation opportunities
• commonly encountered objections/obstacles to
donation
Upcoming workshops:
For further information or registration:
2nd and 3rd September 2015
DonateLife Victoria
[email protected]
Phone 8317 7400
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Austin guidelines
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Family Communication and Donation
Conversation:
A Process Not an Event
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Goals of the donation discussion
• An ‘enduring decision’
• The family makes a decision that is ‘right’ for
them with the passage of time
• The decision the family made was in keeping
with what their family member would have
wanted
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End of Life Care & Organ
Donation
First Priority
Care of the dying or deceased patient and their
family
 Sensitivity to cultural, religious and social needs
 Pastoral Care and Social Work
Second Priority
The organ donation process.
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Raising donation
 Separate conversation – “decoupling”
 Acceptance of brain death diagnosis,
Or
 Acceptance of imminent death
 Appropriate requestor
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Approaching Donor Families
The best person is a health care professional who:
 Does not request organ donation but empowers
the family to make the right decision for
themselves and their loved one
 Feels positive about organ donation
 Knowledge about the process, training and
expertise
 Is sensitive and understands the needs of
suddenly bereaved people
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Conversation Approach
Balanced Approach
Neutral-----------------------Informed, Proactive------------------------Coercive
Simple, closed-ended
question; not much
information
Sense of pressure;
might feel like
emotional blackmail
Includes information about the good that can come
from donation in an open, respectful manner
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Success is not be measured in terms of
donation rates or consent rates
but rather as the proportion of families who at the
end of the process believed they had made the
right decision for their family
(“yes/no”)
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Our hospitals experience
 >90% referral rate
 Never had a family offended by staff
raising the option of donation
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Key points: Discussing donation
• Organ donation is a rare event
• Offering donation - it’s more than a single question!
• The aim is for the family to reach an enduring donation decision, and one
which is consistent with what their family member would have wanted
• Donation is raised through optimal timing, skilled communication and
accurate information
• DonateLife staff are always available to provide advice and guidance and
receive referrals.
• Every family, every time – have the right to have donation discussed as
part of their end of life care
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Thank you 
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