Procedure of organ donation | Organ Transplantation

Procedure of organ donation

If an organ donor dies, their personal data will be forwarded to the German Foundation for Organ Transplantation (DSO), which in turn contacts the highest authority called Eurotransplant. Eurotransplant is a medical center that coordinates the allocation of organ transplants throughout Europe. Once a suitable organ has been found for a patient on the transplantation list, everything must be done quickly.

After the death of the donor, the tissue becomes increasingly damaged over time and therefore, for a successful transplantation, it must be rinsed with a tissue-preserving solution, stored in a cool place and used quickly. The various organs have different shelf lives outside of the functioning physical circulation. The heart has the shortest shelf life of only 4 hours.

In the case of the larger organs, the kidneys can be transplanted with the greatest time interval – within 36 hours. Corneas are not subject to as strong blood circulation as the other organs, are therefore more robust and can be stored refrigerated for up to 72 hours. All potential organ recipients must therefore be contactable at all times so that an immediate referral to a suitable hospital can be made.

Within 2 to 3 hours the organ recipient must be able to present himself at the responsible transplant center. In the case of a living donation, the operation can be better planned and performed without the time pressure. A large number of discussions and examinations should encourage both sides to reconsider the operation and ensure the compatibility of the tissue transferred.

The donor must explain his or her final decision to a commission, which can then decide for or against the operation. It must be ensured that the donor acts of his own free will. The organ recipient must also be prepared for the operation.

This preparation includes an early and extensive examination as well as influencing the patient’s immune system. On the one hand, the examinations serve to identify risk factors such as inflammation and certain high-risk pre-existing conditions. In addition to the laboratory diagnosis of blood and urine, an ECG is written, an X-ray of the lungs is taken, the abdomen is examined by ultrasound and a colonoscopy is performed.

In addition, the patient’s blood group must be determined and the tissue typed to minimize the risk of a rejection reaction. Another aspect of preparing the patient for organ transplantation is the so-called immunosuppression. Here, the immune system is suppressed as far as possible to keep the body’s reaction to the foreign organ as low as possible.The operation itself is performed with varying degrees of effort depending on the organ.

Organs that are components of the circulatory system – heart and lungs – must be replaced during the operation by a heart-lung machine in their function. This is a very extensive procedure, which results in a long stay in hospital and extensive rehabilitation measures. The function of the transplanted organ must be constantly monitored in the period after the operation in order to ensure the health of the patient on the one hand and to check whether the organ is accepted by the recipient organism on the other.