Organ and tissue donation

Organ and tissue donations are medical processes that save and transform lives. Organs are retrieved from a donor and transplanted into someone who is very sick on the Australian transplant waiting list, while tissue donors help transform lives through eye and tissue donations.

The anonymity between donor and recipient is upheld in accordance with the Human Tissue Act of 1983. Australia has one of the best transplant success rates in the world and research shows that the majority of Australians support organ and tissue donation.

What is donation?

Donation is the giving of an organ and tissue to help someone that needs a transplant.

A transplant can save or transform the life of a person. One organ donor can save up to 7 lives and help many more through eye and tissue donation. This relies on donors and their families agreeing to donate their organs and tissue after death.

Why is donation important?

At any one time, there are around 1,750 Australians on the organ transplant waiting list. Unfortunately, there are fewer donor organs available than there are people waiting. Some people die waiting for a transplant. Some spend weeks or months in hospital, while others make several trips to hospital every week for treatment.

People who need an organ transplant are usually very sick or dying, because one or more of their organs is failing. They range from children through to older Australians.

Many on the organ transplant waiting list have a congenital or genetic condition, illness or sudden organ failure that will make them very sick and in need of a transplant.

We never know when illness could affect a family member, friend or colleague who may need a transplant.

Pathways to organ donation

There are three pathways to organ donation:

• Brain death - This is where a person no longer has blood going to or activity in their brain due to a severe brain injury. They have permanently lost the potential for consciousness and the capacity to breathe. This may happen even when a ventilator is keeping the person's heart beating and oxygen is circulated through their blood.

Brain death is not the same as being in a coma. A person in a coma is unconscious because their brain is injured in some way. In a coma, the brain continues to function and may heal. With brain death however, there is no possibility of recovery as the brain has ceased to function and cannot recover.

For brain death, a series of tests are carried out by two independent and appropriately qualified senior doctors to establish that death has occurred.

• Circulatory death - Is the irreversible loss of function of circulation after a cardiac arrest from which the patient cannot or should not be resuscitated. It can also be the planned withdrawal of life-sustaining treatment from a patient within the Intensive Care Unit or the Emergency Department.

For circulatory death, the patient is monitored closely and donation will only proceed once circulation irrevocably ceases. Timeframes are very short for this pathway of organ donation because organs cannot be without oxygenated blood and outside the body for a long period of time.

• Living donation - While you are still alive you can choose to donate a kidney, a small section of your liver, or discarded bone from a hip or knee replacement. There is also a joint Australian and New Zealand programme called the Australian and New Zealand Paired Kidney Exchange that helps people who need a kidney transplant, but don’t have a compatible live donor.

Registering to be a donor

Organs and tissue from a donor will only be used when a donor or their family gives consent after the donor has died.

The Australian Organ Donor Register is the official national register for people 16 years of age or older to give their intention to be a donor. Recording your decision on the Register ensures authorised healthcare professionals anywhere in Australia can check your donation decision at any time. In the event of your death, information about your decision will be provided to your family.

Even if you have previously expressed an intention to donate organs and/or tissues, it’s very important that you record your decision on the Australian Organ Donor Register. In Victoria, it is no longer registered on your driver licence.

Ways you can register your donation decision, or check if you are registered, include:

• Visit the DonateLife website and register online in one minute. You will need your Medicare Card. The same process will tell you if you are already registered.
• Sign into your Medicare account on MyGov or on the Express Plus Medicare mobile app (Services Australia) where you can register in three taps.
• Call the Australian Organ Donor Register to register over the phone or ask for a registration form to be mailed to you: Tel. 1800 777 203

You can decide to donate specific organs or tissues, all simply select all organs and tissue. Health professionals will assess at the time of death what organs and tissue could be safely transplanted to someone else. Donation can involve:

• Organs – kidneys, heart, lungs, liver, stomach, intestines and pancreas.
• Tissues – heart valves and tissues, pancreas islets, bone and tendons, skin, and eye tissue.

For general enquiries about organ and tissue donation locally, phone DonateLife Victoria: Tel. (03) 8317 7400

If you don’t want to become an organ and tissue donor, you can also register your decision not to donate on the Australian Organ Donor Register.

Factors that could affect donation

There are very few medical conditions that would impact on the possibility of someone becoming a donor.

You should not rule yourself out based on a medical condition or your age. At death, a detailed assessment is conducted by qualified health professional involved in your care to decide whether some or all organs and tissue are suitable for transplant.

Having the right conditions to facilitate donation is rare - less than two per cent of all people who die in hospital each year are medically suitable to become organ donors. This is why it’s important you register your decision to be an organ and tissue donor and to share your decision with your loved ones.

Organ and tissue allocation

Australia has strict ethical guidelines about the allocation of organs and tissue.

Allocation depends on a prospective ‘match’ between the donor and the potential recipients on the waiting lists. The process also considers the medical urgency a particular person may need a transplant and the length of time they have been on the waiting list for transplantation.

A person’s race, gender or status is not taken into consideration.

Eye and tissue donation

A greater number of people can donate tissue for transplantation than organs. Unlike organs, tissue may be stored for a period of time after donation, and can be retrieved up to 24 hours after death, regardless of where the donor died.

For more details on eye and tissue donation visit DonateLife – Eye and tissue donation awareness.

Why you should share your decision

If you are in a position to donate organs or tissue and you have registered, DonateLife will ask your senior next-of-kin to support your decision to be a donor. Letting them know what you've decided now makes it much easier for them.

In the hospital, 8 in 10 families say yes to donation if their family member had registered to be a donor. However, only 4 in 10 families say yes to donation when they are uncertain about what their loved one wanted.

Knowing donation is what you wanted could make their decision a lot easier when they are trying to deal with their loss.

The best way to help others after your death is by:

• Joining the Australian Organ Donor Register
• Talking about your decision with family and friends

Don’t leave it solely up to your family to decide whether or not to donate your organs and/or tissues. Let them know your donation decision.

DonateLife supports organ and tissue donations

DonateLife Victoria is a network of doctors, nurses, organ donor coordinators, family support workers and other professional staff, joint-funded by the State and Federal Governments. The Australian Organ and Tissue Authority is responsible for coordinating a nationally consistent approach across jurisdictions. The DonateLife network is responsible for identifying potential organ and tissue donors in Australian hospitals, providing information and support to families, and coordinating the process of donation for transplantation.

DonateLife Victoria also works to educate and raise awareness of organ and tissue donation in the community, supported by a strong network of active volunteers. It provides information about organ and tissue donation, including resources, fact sheets and profiles stories from donor families and transplant recipients in the media.

Where to get help

• Your GP (doctor)
• DonateLife Victoria
• DonateLife Facebook page
• The Australian Organ Donor Register Tel. 1800 777 203