Donate Life: An Overview of Organ, Tissue and Eye Donation

1. Donate Life: An Overview of Organ, Tissue and Eye Donation University of Wisconsin Organ and Tissue Donation

2. Why is donation so important?

3. The Numbers Speak for Themselves More than 118,500 people in the United States are waiting for an organ transplant, thousands more are in need of tissue or cornea transplants as well More than 1,812 of the people listed are children who are waiting for organs Every 11 minutes another name is added to the organ transplant waiting list 19 people die every day on the organ transplant waiting list Organ Transplant Waiting List: Type of Transplant# of Patients Waiting in the U.S.In Wisconsin Kidney 96,806 1,812 Liver 15,776 247 Heart 3,533 58 Kidney-pancreas 2,063 51 Lung 1,667 34 Pancreas 1,188 13 Intestines 259 1 Heart-lung 44 0 Total patients118,596 2,168 Source: Organ Procurement and Transplant Network. Updated 7/26/2013

4. Together we can save people like Tyler, who is a thankful double lung recipient. Transplanted at age 16, he recently graduated from high school. Tyler is doing great!

5. Organ Donation Challenges: Donors, Transplants and Patients Waiting We need to close this gap! *Data based on snapshot of the UNOS, OPTN waiting list and transplants on the last day of each year.

6. Why are we learning this in driver’s education class?

7. Kelly Nachreiner Law (Wisconsin Act 124) • Signed by Governor Tommy Thompson on May 9, 2000 • Requires all driver’s education programs in Wisconsin to give at least thirty minutes of instruction on organ and tissue donation • The law was the first of its kind in the U.S. There are now more than 12 other similar educational mandates Kelly Nachreiner, Sauk City, WIOrgan donor on January 4, 2000

8. What organs can be donated?

9. Kidneys We have two kidneys, which can be given to two different recipients for conditions such as: Organs that can be donated: Liver For conditions such as: • Hepatitis A,B,C • Cirrhosis (alcohol, medications) • Biliary Disease • Metabolic • Neoplasms • End stage renal disease • Diabetes with renal disease • High blood pressure • Polycystic kidney disease

10. Heart For conditions such as: Cardiomyopathy Coronary artery disease Congenital heart disease Valvular heart diseases Lungs For conditions such as: • Emphysema/COPD • Cystic fibrosis • Pulmonary fibrosis • Primary pulmonary hypertension • Congenital defects

11. Kidney and Pancreas Isolated Pancreas Diabetes Type I without renal disease Hypoglycemic unawareness Pancreas after kidney transplant • Diabetes Type I with end-stage renal disease Small Intestines For conditions such as: • Short gut syndrome • Severe vascular disease • Frequently transplanted in children

12. What tissues can be donated?

13. Tissue Donation • Skin • Bone • Connective tissue (ligaments & tendons) • Heart valves • Veins • Corneas Approximately 1 million tissue transplants are performed in the US each year.

14. Eye Donation • Cornea transplants become necessary when the cornea becomes cloudy or damaged due to disease, injury or hereditary conditions • Other eye tissue can be used for transplant, research and/or education • Almost anyone can be an eye donor, even patients with poor eyesight, those who wear glasses or contacts and patients with diseases like diabetes and cancer • More than 45,000 cornea transplant surgeries are performed each year in the U.S.

15. The difference between organ donation and tissue/eye donation • Tissue/Eye Donation • Occurs in the first 24 • hours after the heart has • stopped beating • The tissues can be preserved and used at a later date • This is a life-enhancing procedure • Organ Donation • The patient must be in a hospital on a ventilator • The organs must be properly preserved and transplanted quickly • This is a life-saving procedure

16. Transporting Organs Organs must be recovered and transplanted into the recipient very quickly. The time from organ recovery to transplant is the organ preservation time. Maximum times are: Heart: 4 to 6 hours Lungs: 4 to 6 hours Liver: 12 hours Pancreas: 12 to 18 hours Kidneys: 72 hours Small Intestines: 4 to 6 hours Both cars and airplanes are used to transport organs from the donor hospital to the transplant center.

17. Through organ, eye and tissue donation... 1 person can: Save up to 8 lives (organ donation) Improve more than 50 lives (tissue and eye donation)

18. Common Questions about Donation

19. Who can be a donor? • Anyone can sign up/register • People should base their decision on how they feel about donation. • Pre-existing medical conditions won’t necessarily exclude anyone from being a donor • People of all ages should make their decision and let the medical professionals determine if they’re eligible at the time of their death

20. Will the doctors do everything they can to try and save me if they know my wishes to be a donor? Yes. Donation is only considered after all efforts to save a patient’s life have been exhausted by the medical team The organ, tissue and eye recovery professionals are a separate team of people from the medical team that is treating the patient. This ensures that there is no conflict of interest Organ, tissue and eye recovery only occurs after death has been declared

21. How does religion relate to donation? The majority of religions support donation and view organ and tissue donation as a charitable act If you or your family has questions, you should talk to your religious leader about donation

22. Will donation disfigure the body? No. Open casket funerals can occur following donation Organs are removed through a surgical procedure, in an operating room Areas where tissue donation occurs are reconstructed and can be concealed by clothing

23. Does donation cost a family money? No. Each recovering agency pays for all expenses associated with the donation process Those costs are passed on to the recipients and their insurance companies The donor’s family is responsible for the funeral expenses

24. Will donation cause any delays with funeral arrangements? No. The recovering agency will make certain the donor’s body is released to the funeral home on time No extra planning is required by families of organ, tissue and eye donors

25. Can you pay to get an organ? No. Organ allocation is strictly regulated by the federal government. Donated organs are matched to the recipients according to these criteria: • Blood type • Medical urgency • Tissue match • Waiting time • Organ size • Immune status • Geographic distance

26. Will the organs be transplanted locally? Yes, if: There are local recipients who match the organ There are no status one* patients in our region. (This rule applies to livers only.) There are no wait list patients in the U.S. who are a perfect tissue type match. (This rule applies to kidneys only.) * A status one liver transplant candidate is the most medically urgent patient on the list and is likely to die within one week without a transplant. Approximately 85-90 percent of all organs donated in the our state are used for transplants here in Wisconsin

27. Can the donor family and recipients meet each other? Yes. Initial contact is coordinated by the recovery organization, due to federal privacy regulations All recipients are encouraged to write to their donor families Meetings can be arranged if both parties sign a consent/ release of information form

28. Who will decide if I become a donor? Healthcare Agent Spouse Adult Children Parents Adult Siblings Adult Grandchildren Grandparents An adult who exhibited special care & concern Legal Guardian Coroner or Medical Examiner Your legal next of kin. If a person’s donation decision isn’t documented (such as being on the Donor Registry), the legal next of kin hierarchy is the order in which consent for donation is pursued:

29. What is the Wisconsin Donor Registry? Launched on March 29, 2010, the registry allows anyone with a Wisconsin Driver’s License or State ID card to legally register to become a donor online at any time at: YesIWillWisconsin.com Registering to be a donor now is legally binding and cannot be overruled at the time of your death by a family member or legal next of kin if you are over the age of 18.

30. What if I already have an orange DONOR dot? • Even if someone already has an orange DONOR dot on their license – if their last license was issued or renewed before March 29, 2010 – they still need to visit the registry website once in order to be entered into the new Wisconsin Donor Registry • Each time you sign up for a new license/ID card or renew your existing license/ID card – you need to continue to answer YES to the donation question on the application form in order to remain on the Wisconsin Donor Registry • If you decide later that you want to remove yourself from the registry – you can do so online at the same website.

31. Why is it so important to register? Less than 5% of people die in a hospital on a ventilator in a manner which allows for the potential of organ donation. But, a much higher percentage of people could still become tissue and/or eye donors, even if organ donation is no longer an option. 5%

32. You can make a difference • 56.4% of Wisconsinites have said “Yes” to the donation question • Register and encourage your friends and family to register and save lives

33. What should I do now?The Three D’s: 1. Decide Take action and sign up to be a donor at any time by going to: YesIWillWisconsin.com and clicking on the orange DONATE button. You can also sign-up to be a donor at the DMV office where you get your license. 2. Document Make sure that your decision is legally recorded on the Donor Registry 3. Discuss Talk to your family about your decision to be a donor – until you turn 18 – your family can overrule your donation decision.

34. What you do makes a difference… ...and lives are changed forever.