When suitable is not suitable enough: medical exclusion to organ donation

Deepak Bhonagiri, Karen Hockley, Nicola Seifert

LifeGift nsw/act, Australian Red Cross Blood Service, Sydney, NSW

Introduction

LifeGift nsw/act state organ donor coordinators are notified of all potential organ donors from metropolitan and regional hospitals in New South Wales and the Australian Capital Territory. Medical suitability of the potential organ donor is assessed individually at the time of referral.

Aim

To identify the number of potential organ donors who were excluded in 2006 and the reasons for exclusion.

Setting and methods

Data were retrieved for the period 1 January to 31 December 2006, and all notifications were reviewed, particularly those deemed medically unsuitable for organ donation. Medical suitability is based on the recommendations of the Transplantation Society of Australia and New Zealand (TSANZ) National Organ Allocation Protocols.

Results

Of 220 notifications to LifeGift nsw/act in 2006, 33 potential organ donors were deemed unsuitable and excluded. The reasons for exclusion included malignancy (7), current intravenous drug use (7), failed physiological support (5), hepatitis B(1) or hepatitis C (3), untreated infection (3), multiorgan failure(3), active high-risk behaviour (2), risk for Creutzfeldt–Jakobdisease (1), previous transplant recipient with acute rejection(1), and breast cancer (current or history) (1). One donor was excluded due to no suitable recipients (1). (Some patients were excluded for more than one reason.)

Conclusions

LifeGift will continue to assess each potential organ donor individually in accordance with current TSANZ protocols to ensure the safety of the potential recipient.