From the Guidelines
Donation after circulatory death is a viable option for increasing the organ donation pool, yielding success in kidney, liver, and lung transplantation, as evidenced by a systematic review of international guidelines and practices 1. When considering donation, it is essential to prioritize the well-being and safety of both the donor and the recipient.
- The maintenance of trust by health professionals and the public is crucial for the long-term success and widespread implementation of donation strategies.
- Standardization of definitions and processes can help avoid variability in practices and heterogeneity of outcomes.
- Organs for transplantation should be equitably allocated within countries or jurisdictions to suitable recipients without regard to gender, ethnicity, religion, or social or financial status, as outlined in the Declaration of Istanbul on Organ Trafficking and Transplant Tourism 1. Key principles to guide donation practices include:
- Optimal short- and long-term medical care to promote the health of both donors and recipients
- Prohibition of organ trafficking, transplant commercialism, and transplant tourism
- Equitable allocation of organs without regard to financial considerations or material gain
- Collaboration between countries to achieve self-sufficiency in organ donation while protecting vulnerable populations. In the context of living donation, it is essential to consider the psychosocial evaluation of potential donors, including their motivations, knowledge, and potential risks, as outlined in guidelines for the psychosocial evaluation of living unrelated kidney donors 1. Ultimately, donation practices should prioritize the health and well-being of both donors and recipients, while promoting equity, justice, and respect for human dignity.
From the Research
Definition and Types of Donation
- Directed blood donation is defined as the donation of blood or its components for the purpose of transfusion into a specified individual 2
- Opt-out organ donation, also known as 'presumed consent', 'deemed consent', or 'deemed authorisation', whereby individuals are presumed or deemed willing to donate at least some of their organs and tissues after death unless they have explicitly refused permission 3
Clinical Application and Considerations
- ABO blood group is closely related to clinical blood transfusion, transplantation, and neonatal hemolytic disease, and is the most clinically significant blood group system in clinical blood transfusion 4
- Directed donation considerations include the risks and benefits, such as transfusion-transmitted infection risk, alloimmunization risk, increased transfusion-associated graft vs host disease risk, decreased expediency in treatment, and increased administrative burdens 2
- A role remains for directed blood donation in specific patient populations, such as individuals with rare blood types or immunoglobulin A deficiencies, because of the difficulties in finding compatible blood for transfusion 2
Informed Consent and Ethics
- Informed consent is the primary moral principle guiding the donation of human tissue for transplant purposes 5
- The primary bioethics principles involved in organ donation are autonomy, beneficence, justice, and utility 6
- The application of bioethical principles is integral to the decision-making process involved in organ-donation issues, and it is the responsibility of healthcare professionals and organizations to understand and determine which principles support a proposed decision on organ donation or allocation 6