A cadaveric donor refers to an individual who donates organs or tissues after being declared deceased. This form of donation occurs post-mortem. Cadaveric donation provides a source of organs and tissues that can save lives and improve the health of many patients awaiting transplants.
Defining Cadaveric Donation
Cadaveric donation, also known as deceased donation, involves the recovery of organs and tissues from an individual who has died. This process differs from living donation, where a living person donates an organ or a portion of an organ. Organs and tissues are recovered only after a person has been declared dead, either by brain death or circulatory death criteria.
Cadaveric donation provides organs for transplantation, often the only treatment option for patients with end-stage organ failure. This type of donation can improve the quality of life for recipients, allowing them to regain health and return to normal activities. The majority of organs available for transplant come from deceased donors.
The Journey of Organ and Tissue Donation
The process of cadaveric donation typically begins in a hospital setting with the identification of a potential donor who has suffered a severe, acute brain injury. Life-saving efforts are first attempted, and only after all such measures have been exhausted is organ donation considered. Death is then declared, either through neurological criteria (brain death) or circulatory criteria (cardiac death). Brain death signifies the irreversible loss of all brain function, including the brainstem, while circulatory death is the irreversible cessation of circulatory and respiratory functions.
Once death is declared, obtaining consent from the donor’s family or next of kin is a step. This decision can be less stressful for families if the deceased had previously registered as an organ donor. Following consent, a medical evaluation of the donor is performed to determine the suitability and health of the organs and tissues for transplant. This evaluation considers various factors, including the donor’s medical history.
After the medical evaluation, the surgical recovery of organs and tissues takes place in an operating room. The donor is treated with respect throughout this procedure. Organs are then perfused with cold preservative solutions and carefully packaged in sterile solutions and ice for preservation. This preservation and subsequent transportation to transplant centers must occur within specific timeframes to maintain organ viability, which can range from a few hours for hearts and lungs to up to 36 hours for kidneys.
What Can Be Donated
Major organs that can be donated include the heart, lungs, liver, kidneys, pancreas, and intestines. The heart is transplanted to treat severe cardiovascular diseases or birth defects, while kidneys are used for patients with kidney failure, often allowing them to cease dialysis. The liver, the body’s largest organ, can be transplanted for various conditions and sometimes even split to benefit two recipients.
Beyond major organs, various tissues can also be donated. These include corneas, skin, bone, heart valves, veins, arteries, tendons, and ligaments. Corneas can restore sight to individuals with damaged corneas due to disease, injury, or birth defects. Donated skin serves as a natural dressing for burn victims, helping to prevent infections. Bone and connective tissues are used in orthopedic surgeries to repair damaged joints, replace bone lost due to illness or injury, and support artificial joint replacements. Heart valves can be transplanted to address defects or damage, and donated veins and arteries are used in bypass surgeries or to connect transplanted organs.
Who Can Be a Donor and Recipient Selection
Eligibility for cadaveric donation is determined on a case-by-case basis, considering factors like age, medical history, and the circumstances surrounding death. Suitability can vary widely depending on the specific organ or tissue. Individuals with certain medical conditions, like active cancer or infectious diseases, may not be eligible to donate. The cause of death, often a severe brain injury from a stroke, heart attack, or trauma, also influences what organs and tissues can be recovered.
Recipient matching is a complex process managed by organizations like the United Network for Organ Sharing (UNOS) in the United States. UNOS oversees the national organ transplant waiting list and allocation system, ensuring fairness and efficiency. The matching system considers various medical and logistical factors, including blood type, tissue type, organ size, and the medical urgency of the recipient. Organ size is important for successful transplants, especially for pediatric candidates who often respond better to child-sized organs.
Other factors influencing recipient selection include the time a patient has spent on the waiting list and geographical proximity between the donor and transplant hospitals. Organs like hearts and lungs have shorter preservation times, making proximity a significant consideration. UNOS’s computerized system screens out incompatible candidates based on these factors and then generates a rank-ordered list of potential recipients, ensuring that personal or social characteristics do not influence priority.