Patients must not have cancer except primary brain tumors, lip/ skin cancers, in-situ carcinomas.
Patients must not be among those classified high risk by the CDC, including homosexual/bisexual males, current I.V. drug abusers, or patients with hemophilia/coagulation disorders.
The identity of the patient must be known. In those cases where the identity of the patient is unknown, the Family Advocate will make an assessment of the circumstance of death that will include discussions with the involved law enforcement agency. Line placement pursuant to the provisions of the Anatomical Gift Amendment Act of 1996 will not occur unless a high probability of patient and next-of-kin identification and notification can be accomplished within four hours after the known time of death.
There are several potential ways to obtain organs from non-heart-beating donors in the intensive care units. Any patient under 60 years old from whom withdrawal of support is anticipated and who is expected to suffer a cardiac death shortly after withdrawal should be considered a potential donor. When such patients seem medically suitable according to the criteria in this document, a member of the primary or critical care term should notify the ODA. After the approval of the responsible intensivist the ODA will contact the Medical Examiners Office (if necessary) and the OPO to evaluate the patient. The OPO coordinator will discuss the potential of organ acceptability with the intensivist. The patient’s attending along with the critical care team will discuss withdrawal of support with the family or person responsible for the patient’s health care decisions. If organs seem acceptable a member of the primary or critical care team will introduce the family to the OPO coordinator who is generally the individual who will discuss the option of organ donation along with the ODA Family Advocate. The family member or other person responsible for the patient’s healthcare decisions may then elect to have organs donated. If consent for organ donation has been obtained, the primary medical team and critical care team will notify the ODA of the impending withdrawal of support. The ODA will communicate with the ROR team and the OPO to coordinate their efforts with the primary or critical care team which will direct the withdrawal process. If the patient dies during or after the withdrawal of support the ROR line placement and preservation protocol will be instituted. A patient will remain in the ICU during this time unless it is determined that the operating room, MedSTAR, or the PACU is the preferred setting.