Organ & Tissue Donation & Transplantation: Working Group Recommendations

1. Organ & Tissue Donation & Transplantation:Working Group Recommendations Rel 300 / Nurs 330 March 2016

2. Consent to use of organs & tissues 300/330 - appleby How will potential organ & tissue donors express and/or document their autonomous decisions with regard to the distribution and/or disposal of their own bodies and body parts? What are the possible procedures or systems for organ & tissue procurement? What procedures and guidelines will you recommend for the recovery of viable organs & tissues for donation, retrieval or storage?

3. Working Group #1:Consent to use of organs & tissues 300/330 - appleby What procedures and guidelines will you recommend for the recovery of viable organs & tissues for donation, retrieval or storage?

4. Working Group #8:Consent to use of organs & tissues 300/330 - appleby What procedures and guidelines will you recommend for the recovery of viable organs & tissues for donation, retrieval or storage?

5. Determining Death – Brain Death 300/330 - appleby How will persons be determined to be dead according to brain death criteria? By what procedures will organs & tissues be retrieved from dying and/or dead persons? What organs & tissues may be retrieved following a determination of brain death? What procedures and guidelines will you recommend for the use of brain death criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

6. Working Group #2:Determining Death – Brain Death 300/330 - appleby What procedures and guidelines will you recommend for the use of brain death criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

7. Working Group #9:Determining Death – Brain Death 300/330 - appleby What procedures and guidelines will you recommend for the use of brain death criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

8. Determining Death – Cardiovascular Death 300/330 - appleby How will persons be determined to be dead according to cardiovascular death criteria? By what procedures will organs & tissues be retrieved from dying and/or dead persons? What organs & tissues may be retrieved following a determination of cardiovascular death? What procedures and guidelines will you recommend for the use of cardiovascular criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

9. Working Group #3: Determining Death – Cardiovascular Death 300/330 - appleby • What procedures and guidelines will you recommend for the use of cardiovascular criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

10. Working Group #10: Determining Death – Cardiovascular Death 300/330 - appleby • What procedures and guidelines will you recommend for the use of cardiovascular criteria in the recovery of viable organs & tissues for donation, retrieval or storage?

11. Donation after cardiac death Allison downing, Jasmine allen, shannalee smith, Rachel berry & analiesemaciel

12. Recommendations Recommendation #1:Participating organizations should support efforts to incorporate donation into end-of-life care to optimize organ and tissue donation in Canada. Individuals should be given the option of organ donation after death, and health care systems should establish the processes and procedures to provide this option. Recommendation #2:Donation services should be offered in the context of maintaining respect for the beliefs and values of the individuals involved.

13. Recommendation #3:From a medical perspective; the three criteria that determines cardio-respiratory death according to two physicians is unresponsiveness, apnea and permanent cessation of circulation. Recommendation #4:A better approach to procure vital organs while protecting vulnerable patients from abuse is to emphasize the importance of obtaining validate and informed consent for organ donation before withdrawal of life-sustaining treatment. Recommendation #5:Across Canada, the definition of death should be created by the federal government, rather than it being governed from province to province.

14. Are there other Potential Donors? 300/330 - appleby • Should organs & tissues be retrieved for transplantation from anencephalic infants? • Should organs & tissues be recovered from persons in a PVS for transplantation? • If Canada should implement regulations for medical assistance in dying, should organs & tissues be recovered from persons who choose to end their lives? • What policies or guidelines will you recommend regarding the recovery of viable organs & tissues for donation, retrieval or storagefrom persons who choose to end their lives?

15. Working Group #4:Are there other Potential Donors? 300/330 - appleby • What policies or guidelines will you recommend regarding the recovery of viable organs & tissues for donation, retrieval or storage from anencephalic infants, persons in a vegetative state, or persons who choose to end their lives?

16. Financial incentives 300/330 - appleby • Should monetary payment programs be developed to increase the donation of organs & tissues from live donors? • What sorts of financial compensation programs might be considered? • Should verifiable expenses be covered to cover any costs incurred by a donor? • What policies or guidelines will you recommend regarding financial incentives to increase the rates of organ & tissue donation, retrieval or storage?

17. Working Group #5:Financial incentives • What policies or guidelines will you recommend regarding financial incentives to increase the rates of organ & tissue donation, retrieval or storage? 300/330 - appleby

18. Xenotransplantation 300/330 - appleby • In order to better meet the demands for healthy organs & tissues, should non-human organs & tissues be used? • What animals might be considered as potential sources of organs & tissues for transplantation? How might this be done? • Are there potential risks and harms to animals used as sources? Are there potential risks and harms to human recipients? • What policies or guidelines will you recommend regarding xenotransplantation to increase the supply of organs & tissues for donation, retrieval or storage?

19. Working Group #6:Xenotransplantation 300/330 - appleby • What policies or guidelines will you recommend regarding xenotransplantation to increase the supply of organs & tissues for donation, retrieval or storage?

20. Transplant Tourism 300/330 - appleby • Should wealthy people in one part of the world be allowed to travel to commercial medical transplant centres in other parts of the world where organs & tissues are made available? • Are there potential benefits, risks and harms to the people used as sources of organs & tissues? • Are there potential benefits, risks and harms to the organ & tissue recipients? • What policies or guidelines will you recommend regarding transplant tourism as a means of providing needed organs & tissues for donation, retrieval or storage?

21. Working Group #7:Transplant Tourism 300/330 - appleby • What policies or guidelines will you recommend regarding transplant tourism as a means of providing needed organs & tissues for donation, retrieval or storage?

22. Working Group #14:Transplant Tourism 300/330 - appleby • What policies or guidelines will you recommend regarding transplant tourism as a means of providing needed organs & tissues for donation, retrieval or storage?