ORGAN DONATION -CON GROUP-

1. ORGAN DONATION-CON GROUP- GROUP MEMBERS Leah Bennett Brittany Deruvo Kristen Boundy Amy Li Jaclyn Christopher Kelleen Stiles James Cozza

3. Truth about Organ Transplants Approximately 35% of organ transplants result in death within 5 years Post-Op transplant patients are bombarded with medications, increasing chance for medication errors Estimated U.S. average billed charges per transplant as of July 1, 2005 are anywhere from $210,000 to $813,000 Not all cultures & religions permit organ transplants Organ transplants have been proven deadly to recipients and donors.

4. Startling Statistics Source: 2005 OPTN/SRTR Annual Report, Table 1.13. US transplant.org, Scientific Registry of Transplant Recipients

5. Organ Donation is DANGEROUS Organs are not tested for some infections and viruses Passive transfer of allergies after transplants Increased chances of medication errors by nurses while in hospital and self-medication errors when released from the hospital

6. Outdated & Risky Transplant Procedures Immunosuppression following transplant masks inflammatory response and masks possible developing infections The surgical procedure is complex and takes many hours There is a high chance of contamination via the gastrointestinal tract Liver transplant recipients are one of the more susceptible transplant groups for infection

7. Living Liver Donation Survey In a 2003 survey, 449 donors filled out a questionnaire regarding their liver donation 65 of the 449 donors had 1 or more complications of partial-liver donation 3 deaths were reported: 1 during the survey and 2 after the survey 38 donors had to be re-hospitalized Others reported need for blood transfusion and re-operation 3 donors were placed on waiting lists for a cadaveric liver

8. Ethics Organ donor lists Is who you are, socio-economically, affect if and when you are eligible for donation? Public solicitation/commercialization of organs Is choosing whether or not to be an organ donor affect the treatment the donor will receive if in a crisis situation via the health care provider?

9. Culture, Religion, and Lifestyles Chinese - In Confucianism, organ donation is looked down upon. Judaism - No organs can be obtained until all respiration, circulation, and heart beat cease. Islam - Some Muslims believe that since Allah gave you your body, you should return it to him in the same form in which it was given.

10. An Increasing Issue Failing hospitals Care to the lowest bidder Need for procedure improvement Unstable health care environment for such invasive procedures Shorter hospital stays and monitoring

11. Our Group� Organization In Alphabetical Order Leah Bennett - Ethics Expert Kristen Boundy - Infection Expert Jaclyn Christopher - Pro Donation Expert James Cozza - Coordinator, Pro Group Liaison Brittany Deruvo - Procedures, Cost Expert Amy Li - Culture, Religion Expert Kelleen Stiles - References, Statistics Expert

12. One of Many Case Studies (time permitting)

13. References Aduen, J.F., Hellinger, W.C., Kramer, D.J., Stapelfeldt, W.H., Bonatti, H., & Crook, J.E., et al. (2005). Spectrum of pneumonia in the current era of liver transplantation and its effect on survival. Mayo Clinic Proceedings, 80(10), 1303-1306. Bos, M. (2005). Ethical and legal issues in non-heart-beating organ donation. Transplantation, 79(9), 1143-1147. Bramstedt, K., Florman, S., & Miller, C. (2005). Ethical challenges in live organ donation. Current Opinion in Organ Transplantation, 10(4), 340-344. Brown, R.S., Russo, M.W., Lai, M., Shiffman, M.L., Richardson, M.C., & Everhart, J.E., et al. (2003). A survey of liver transplantation from living adult donors in the United States. The New England Journal of Medicine, 348(9), 818-825. Chang, G.C., Wu, C.L., Pan, S.H., Yang, T.Y., Chin, C.S., & Yang, Y.C., et al. (2004). The diagnosis of pneumonia in renal transplant recipients using invasive and noninvasive procedures. Chest, 125(2), 541-547. Chisholm, M.A., & Garrett, C.J. (2001). Increasing transplant patients� access to medications: Medicare and beyond. American Journal of Health-System Pharmacy, 58(21), 2081-2084. Dykstra, A. (2004). Should incentives be used to increase organ donation? American Society of Plastic Surgical Nurses, 24(2), 70-74. Gillman, J. (1999).Religious perspectives on organ donation. Critical Care Nursing Quarterly, 22(3), 19-29. Hollenbeak, C.S., Alfrey, E.J., & Souba, W.W. (2001). The effect of surgical site infections on outcomes and resource utilization after liver transplantation. Surgery, 130(2), 388-395.

14. References Kondro, W. (2005). Debate over online recruitment of organ donors. Canadian Medical Association Journal, 172(2), 165-166. Martinenghi, S., Dell'Antonio, G., Secchi, A., Di Carlo, V., & Pozza, G. (1997). Cancer arising after pancreas and/or kidney transplantation in a series of 99 diabetic patients. Diabetes Care, 20(3), 272-275. Mubareka, S., Vinh, D.C., & Sanche, S.F. (2005). Candida dubliniensis bloodstream infection: A fatal case in a lung transplant recipient. Transplant Infectious Disease, 7(3-4), 146-149. Ojo, A.O., Held, P.J., Port, F.K., Wolfe, R.A., Leichtman, A.B., & Young, E.W., et al. (2003). Chronic renal failure after transplantation of a nonrenal organ. The New England Journal of Medicine, 349(10), 931-940. Phan, T.G., Strasser, S.I., Koorey, D., McCaughan, G.W., Rimmer, J., & Dunckley, H., et al. (2003). Passive transfer of nut allergy after liver transplantation. Archives of Internal Medicine, 163(2), 237�239. Rabies kills four transplant recipients. 2004. Nursing 2006, 34(9), 34. Rassin, M., Lowenthal, M., & Silner, D. (2005). Fear, ambivalence, and liminality: Key concepts in refusal to donate an organ after brain death. Jona's Healthcare, Law, Ethics, & Regulation, 7(3), 79-83. Rhimes, S. (Writer), & Goldwyn, T. (Director). (2005). Winning the battle, losing the war [Television series episode]. In S. Rhimes (Producer), Grey�s Anatomy. Los Angeles: American Broadcasting Company. Salim, A., Velmahos, G.C., Brown, C., Belzberg, H., & Demetriades, D. (2005). Aggressive organ donor management significantly increases the number of organs available for transplantation. Journal of Trauma, 58(5), 991-994. Shorr, A.F., Abbott, K.C., & Agadoa, L.Y. (2003). Acute respiratory distress syndrome after kidney transplantation: Epidemiology, risk factors, and outcomes. Critical Care Medicine, 31(5), 1325-1330.

15. References Simmerling, M., Angelos, P., Franklin, J., & Abecassis, M. (2006). The commercialization of human organs for transplantation: the current status of the ethical debate. Current Opinion in Organ Transplantation, 11(2), 130-135. Singh, N., Squier, C., Wannstedt, C., Keyes, L., Wagener, M.M., & Cacciarelli, T.V. (2006). Impact of an aggressive infection control strategy on endemic Staphylococcus aureus infection in liver transplant recipients. Infection Control and Hospital Epidemiology, 27(2), 122�126. Steinbrook, R. (2005). Public solicitation of organ donors. The New England Journal of Medicine, 353(5), 441-444. Truog, R. (2005). The ethics of organ donation by living donors. The New England Journal of Medicine, 353(5), 444-446. West Nile virus infections in organ transplant recipients�New York and Pennsylvania, August�September, 2005 [Electronic version]. (2005). Morbidity and Mortality Weekly Report, 54(40), 1021-1023. Retrieved October 30, 2006, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a5.htm Wilkinson, T.M. (2003).What's not wrong with conditional organ donation? Journal of Medical Ethics, 29(3), 163-164.