ORGAN DONATION

• Organ Donation


  • it is the process of removing tissues or organs from a live, or recently dead, person to be used in another
• Organ transplantation


  • an accepted life saving therapy for patients with end stage organ diseases. To date, in many countries, almost all vital organs can be successfully transplanted: kidney, liver, heart, pancreas, lungs, and small bowels (intestine)
  • surgical operation in which you remove or replace failing or damaged organs in humans.
• Artificial organs


  • have mechanical or biochemical functions, even the mass exchange functions which are almost similar to ones that could be found on a living/deceased donor; They are engineered device
  • Most utilized is the heart (ex. ventricular assist devices or total artificial heart)
• Donor


  • refers to an individual who voluntarily donates organ, tissue, or part thereof, gratuitously to another who accepts it
  • it can come from people of all ages but it’s still case to case basis
• Recipient


  • an individual who received the organ or tissue through transplantation
  • it’s not only exclusive to an individual who have end-stage organ disease
  • It is possible that the recipient is an:
  • accredited medical or dental school
  • tissue bank storage facility
  • individual in the national transplant waiting
• Accredited medical or dental school


  • cadavers are being used for education purposes, research, advancement of medical/dental science or therapy
• Tissue bank storage facility


  • used also for research, therapy and for medical/dental education
• Individual in the national transplant waiting list 


  • ''transplant recipient/organ graft''
  • an individual who received the organ
• PhilNOS (Philippine Network for Organ Sharing)


  • created and established by DOH under A.O 2010-0019 in June 23, 2010
  • The purpose of PhilNOS is to serve as the central coordinating body for organ sharing, donation, and transplantation activities in the Philippines.
  • All donated organs must go through PhilNOS, which prioritizes individuals who require the most support.
  • The most commonly transplanted organ is the kidney, which has the highest success rate and is supported by a dedicated Transplant Institute. The liver is also frequently transplanted.
• Types of Donor


  • Living Donor
  • Living related donor
  • Living non-related donor
  • Deceased/Cadaveric Donor
• Living Donor


  • an individual who is willing to donate an organ, tissue, or part of the body while still alive
  • must be 18 years old and above
  • must have no existing clinical conditions
• Living related donor


  related to the recipient by blood within the fourth civil degree of consanguinity
• Living non-related donor


  • not related to the recipient by blood or related by blood beyond the fourth civil degree of consanguinity but who is willing to donate organs, tissues, or parts thereof.
  • Voluntary donors and Commercial donors
• Voluntary donors


  • who are “related emotionally” to the patient
  • spouse, friends, fiancee, colleagues, adaptive parents/child/sibling
• Commercial donors


  • Organ vendors who sell their organs are not recommended. While this practice is not officially recognized in the Philippines, it can occur in the black market.
  • When organs are compatible with a recipient, there is no need to go through the waiting list, as a specific target recipient is identified. The organs typically involved include the liver, small intestine, kidney, pancreas, and skin.
  • In the black market, healthy individuals may be contracted to donate an organ for money, but they still undergo screening for organ donation.
• Deceased/Cadaveric Donor


  • individual who has just died and was previously known to be a healthy patient who has suffered irreversible catastrophic brain injury of known etiology
  • This includes individuals from vehicular accidents. Only a small percentage of patients who die in hospitals meet the criteria for organ donation.
• Brain death


  refers to the irreversible cessation of all functions of the entire brain
• Criteria to consider when evaluating potential donors:


  • Comatose, not breathing spontaneously
  • Sustained irreversible neurological damage
  • Fixed pupils and no reflexes
  • No known condition, free of sepsis (bacterial infection that could be life-threatening), and free of transmittable disease
  • No malignancy other than primary brain tumor
  • No history of malignant hypertension or renal disease
• Potential multiple organ donor 


  • patients who will imminently become brain dead but met the criteria and can donate more than one organ
• How to determine if a donor is eligible?


  1. He/she must be 18 years old and above
  2. No existing clinical conditions
  3. Free from risk factors for, and clinical evidence of, infection due to relevant communicable disease agents and diseases
  4. The results of donor testing for relevant communicable disease agents are negative or nonreactive
  5. Free from communicable disease risks associated with xenotransplantation
• Xenotransplantation


  • The procedure involving transplantation, implantation, or infusion in which the recipient is a human and the organ, cells, or tissue come from non-human animals
• Organs and Tissues that can be donated


  • Heart - Cornea
  • Lungs - tendons
  • Liver - valves
  • Kidneys - veins
  • Intestine - skin
  • pancreas - bones
• The organ should be transplanted within after it has been harvested from the donor


  • Heart: 4-6 hours
  • Lung: 4-6 hours
  • Liver: 8-12 hours
  • Pancreas: 12-18 hours
  • Kidney: 24-36 hours
  • Intestines: 8-16 hours
• Average waiting time for kidney donation according to National Kidney Foundation:


  • USA (3-6 years), Canada (4-5 years), UK (2-3 years)
  • 113,000 people wait for an organ transplant contrast to the 18, 000 organ donated in 2012
• Organ specific allocation criteria


  • Used for criteria for the suitability and matching of the donor to the patient
  • Qualified patients are those in the end stage of their condition but whose bodies can still manage the transplantation
  • DASS (Donor Allocation Scoring System)
  • OSASS (Organ-Specific Allocation Scoring System)
  • OTC (Organ transplant Candidate)
  • Kidney Transplant Candidate (KTC)
  • Liver Transplant Candidate (LTC)
  • Philippine Organ Donor and Recipient Registry System (PODRRS)
• Donor Allocation Scoring System


  it is a national scoring system by which allocation of organ grafts from deceased donors shall be based
• Organ-specific allocation scoring system


  • national scoring system by which allocation of organ grafts from donors shall be based; specific organ
• Organ transplant candidate


  • patient with end-stage-organ-disease (ESOD) who is possible to receive an organ (Kidney or liver); medically suitable to receive an organ graft
• Kidney transplant candidate (KTC)


  • individuals with end-stage-renal-disease (ESRD) who is qualified to receive a kidney graft
• Liver transplant candidate (LTC)


  • individuals with end-stage-liver-disease (ESLD), acute liver failure, or specific metabolic disorder who is qualified to receive a kidney graft
• Philippine Organ Donor and Recipient Registry System


  • system that contains a national computerized database of all the organ transplant candidates, transplant recipients, and organ donors
• Hospital transplant candidate waiting list


  • database of all potential organ recipients (Ex. NKTI)
  • Clinical Transplant Coordinator – responsible for transplant program of the hospital (screening of donors and potential recipients)
  • Transplant centers – database is shared with the national candidate waiting list
• National Transplant Candidate waiting list


  • It is compiled from the waiting lists of different accredited transplant centers across the country, sourced from hospital transplant candidate waiting lists.
  • Upon the attending physician's recommendation, a person is deemed qualified as an organ recipient and undergoes multiple screening tests. Once qualification is confirmed, their name is added to the waiting list and the national database.
  • The distance between the organ donor and recipient is always considered and can affect waiting list priority.
• Status 1


  • highest priority for liver transplantation
  • acute liver failure/disease
  • estimated survival of less than 7 days
• Status 2a


  • MELD score >29
  • ESLD (end-stage liver disease), severely ill, potentially hospitalized
• Status 2b


  • MELD score 24-29
  • ESLD (end-stage liver disease), severely ill, not requiring hospitalization
• Status 3


  • MELD score <24
  • suitable live donor transplantation candidate
  • too early for cadaveric transplantation
• Transplant Screening Test


  • Regardless of the organ being transplanted, whether living or cadaveric, special blood tests are required for matching the donor to the recipient.
  • The National Transplant Cannulate Waiting List is divided into areas of responsibility: NCR, regional, and national, based on geographical location.
  • Blood Type Test
  • HLA Test
  • Crossmatch
  • Serology
• Blood Type Test


  • The first test establishes the ABO blood type for both donor and recipient. Blood type O donors are allocated to blood type O recipients first. Blood type O can be allocated to other types only in urgent cases (Status 1A). Donors of other blood types are matched with their respective compatible recipients (e.g., blood type A donor to blood type A recipient).
  • It should be the same or compatible blood type. Compatibility is important because blood type O can be donated to other blood types. The Rh blood group system is not a factor in donor matching.
• HLA (Human Leukocyte Antigen)


  • The tissue type of all potential donors is considered in donor selection
  • Also known as Tissue typing, can be found in various tissues of the body, mostly in white blood cells
  • Tissue type similarity among family members can range from identical (100%) to none (0%) This is why family members are often considered potential liver or kidney donors