Where Will my New Pancreas Come From?
Donation after Brain Death
The most common type of organ donor is a person who suffered a head injury that caused brain death. “Brain death” occurs when someone does not get enough oxygen. This causes the brain to stop working. It is often due to trauma or a stroke. Doctors can tell when someone is brain dead by testing certain reflexes controlled by the brain. They use machines that look at blood flow to the brain. The brain controls breathing so people who are brain dead are in a hospital on a breathing machine called a ventilator. Because of the breathing tube and certain medicines, the person’s body can function even after brain death. This allows the heart to keep beating and supply the pancreas and other organs with blood and oxygen until a transplant team can arrive.
Donation after Cardiac Death
Sometimes the trauma is so severe that doctors cannot save the patient’s life, but they do not meet the measures for “brain death.” The doctors then discuss with the patient’s family whether or not to remove life support. If the family chooses to remove life support, the machines are turned off. The patient is allowed to die peacefully. Sometimes, these patients can be organ donors. Transplant teams are called and are present when the life support is turned off. After the heart stops beating and the patient is declared dead by the doctor, the transplant teams can remove the organs. This is called Donation after Cardiac Death (DCD). Because the heart has stopped beating in these donors, there is a lack of blood flow for a short time to the organs as they are removed. Because of this, a pancreas from a DCD donor may sometimes take a few days to make enough insulin to control glucose levels. The blood pancreas enzyme level may also rise in the first few days after transplant. But, the outcomes for patients who receive a pancreas from DCD donors are the same as with brain death donors.
What will I be told about my donor?
Patient confidentiality laws limit how much we can tell you about your donor. We cannot tell you the donor’s age, gender, or personal or health history. Guidelines for allocating pancreases are set by the United Network for Organ Sharing (UNOS). The Organ Procurement Organization (OPO) informs the UW Transplant Program when a pancreas is found and who is number one on the UNOS list to receive it. The OPO has a thorough screening for all would-be donors to attempt to find any illness that could affect the transplant organ or the patient who receives it. Screening for such an illness can be limited by time constraints between the time that the donor was injured and the organ obtained. We use our best knowledge and judgment to attempt to ensure every organ we transplant will function and will in no way harm the patient who receives it.
“High Risk” Donors
You may be offered an organ from a deceased donor that is thought to be high risk for spreading certain infections according to the Center for Disease Control (CDC) guidelines. Donors are considered “high risk” because of what the CDC deems to be a high risk behavior such as prostitution, intravenous drug use, or homosexuality. It is not the norm to accept organs from such donors unless we feel that the good far outweighs the would-be risk. Blood tests are done on potential donors to look for a virus such as HIV, Hepatitis B, or Hepatitis C. No test is perfect, and false negative results rarely occur. Using data from organ, tissue, and blood donors we know there is a small chance, between 1 in 60,000 to 1 in 2,000,000, that an infectious agent could be passed on. We believe that the risks of getting this type of pancreas are very small or we would not suggest that you accept it. The transplant coordinator will inform you at the time that the pancreas is offered if it is from a high risk donor. You would then decide whether to accept this type of pancreas. If you choose not to accept it, you will not lose your place on the waiting list.
How do I choose?
Members of the transplant team can provide more information about this topic. They can help you choose the type of transplant that may be best for your own case.
The Spanish version of this Health Facts for You is #6760.
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Last Updated: 09/21/2012
Copyright © 10/13/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6696
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