Organ donation involves transferring life-saving organs and tissues to recipients with end-stage organ failure. The process typically focuses on functioning organs like the heart, lungs, liver, kidneys, pancreas, and small intestine. Many tissues are also recoverable, including corneas, skin, bone, and heart valves. However, not every part of the human body can be used for transplantation. The ability to donate depends on current surgical limitations, the physiological nature of the structure, and the donor’s overall health at the time of death.
Anatomical Parts Not Transplanted
The central nervous system, which includes the brain and the spinal cord, represents the most significant anatomical structure that cannot be transplanted. This exclusion is due to the current impossibility of reconnecting the vast and intricate network of neural connections. The brain contains billions of neurons that communicate with the body through the spinal cord, which is a massive bundle of nerve fibers.
If this neural connection were severed during a transplant, no existing medical technique can precisely re-fuse the millions of tiny nerve endings to their correct counterparts. Unlike some peripheral nerves, the nerve fibers within the central nervous system lack the capacity to regenerate and repair themselves effectively after being cut. A transplant of the brain or spinal cord would result in a body that could not send or receive signals, rendering the procedure non-functional.
Tissues and Structures Excluded from Standard Protocols
Certain tissues are generally not utilized in standard deceased organ donation for functional transplantation or are handled through separate processes. Hair and nails are not transplanted because they are composed of non-living, keratinized cells. Furthermore, hair follicles are living tissue, and if transplanted, the recipient’s immune system would immediately recognize them as foreign and attack them.
While a person’s own hair can be transplanted from one part of their scalp to another, accepting a donor’s hair would necessitate the recipient taking powerful, lifelong immunosuppressant drugs. The risk and side effects of these medications are not justifiable for a non-life-saving, cosmetic procedure. Bodily fluids like blood and plasma are also excluded from the organ donation process. They are collected and stored through dedicated, established blood donation systems.
Medical and Situational Exclusions
Organs that are transplantable, such as a heart or kidney, may be excluded based on the donor’s medical condition or the circumstances surrounding the donation. An exclusion criterion for donation is the presence of an active, systemic infection like uncontrolled sepsis, which risks transmitting the disease to the recipient. Certain severe viral infections, such as Creutzfeldt-Jakob disease, are also contraindications due to the high risk of transmission and poor prognosis.
Metastatic cancer prevents donation because it carries a high risk of transferring malignant cells to the recipient. However, organs from donors with a history of successfully treated, localized cancers, such as non-melanoma skin cancer, may still be considered. While age was once a limiting factor, there is no upper age limit for donation; the organ’s physiological condition is more important than the donor’s chronological age.
The quality and function of the organ itself can lead to exclusion, regardless of the donor’s health history. An organ that has suffered significant damage due to trauma or disease, such as a heart with poor pumping function or a liver with severe cirrhosis, is deemed unsuitable for transplant. The timing of the recovery procedure is also a factor, as organs have a limited viability outside the body, known as cold ischemic time. If the time between organ recovery and transplant is too long, the organ may become damaged and be rejected for use.