800-DONORS-7 • core.org
Advisory Committee on Organ Transplantation Informed Authorization for
Vascularized Composite AllograftKurt Shutterly
Chief Operating Officer
800-DONORS-7 • core.org
Legal Aspects of Donation
• Authorization– Family Authorization– First Person Authorization
• Pronouncement of Death• Medical Examiner/Coroner Communication
800-DONORS-7 • core.org
Authorization Requirements for Organ Donation
• Brain Death and Cardiac Death• When to Approach:
– Brain Death Pronouncement– Family Decides to Withdraw Support
• DNR/CMO Patient
– Unstable Potential Donor
800-DONORS-7 • core.org
First Person Authorization
• Drivers License• Living Will• Donor Card• Authorization Document
800-DONORS-7 • core.org
Matching the Donor and Recipient for VCA
• Selection Criteria from TX Center• Screening• Identification Process• Donor/Recipient Match
800-DONORS-7 • core.org
Providing the Opportunity for Vascularized Composite Allograft (VCA)
• The “Request for the Gift”– When to approach?– Recipient information– Authorization required
• First person authorization
800-DONORS-7 • core.org
Informed Authorization
• No Additional Costs• Funeral Home Viewing
– Reconstruction– Prosthesis
• Recipient Information• Media• Donor Family Follow Up
800-DONORS-7 • core.org
Recovery Process
• Coordination• Preparation of Hand and Forearm• Perfusion• Retrieval• Transportation• Reconstruction• Follow Up
800-DONORS-7 • core.org
An Organ Procurement Organization’s Experience with VCA
• Donor Families support VCA• Five hand Transplants in 18 months
– Ability to do much more
• National List needed for Allocation• Reconstruction and Funeral Home Relations
800-DONORS-7 • core.org
Post Donor Review
• It’s all about the “Gift”• Funeral Home • OR Staff• Donor Hospital • Transplant Surgeons
800-DONORS-7 • core.org
CAMC General Feedback
CRNAI was thrilled to take part in this particular CORE case. This is the ultimate gift in my opinion, and I want you and your organization to know that you always have my support.
Being able to take part in that groundbreaking case was wonderful and overwhelming.
Donor Advisory Group Member
• I was very excited and thrilled about this unique situation since we had been doing kidney transplants and organ donation for over 20 years
Hospital Chaplain
I acknowledged her generous gift of life that she shared with another in need and told the mother that this was the first gift of this kind that we had ever had donated from CAMC.
800-DONORS-7 • core.org
Transplanted
J.A.,female, 27 yearsOccupation – Student/MotherCause of Amputation: ischemic gangrene after Nota virus infection 2004Amputation: both lower and upper limbs Amputation level: distal wrist and fingersTransplant Side: Right wrist
800-DONORS-7 • core.org
Transplanted
S.A.,female, 33 years, RHDOccupation – Customer Service AgentCause of Amputation: ischemic gangrene after Meningococcal septicemia 2003Amputation: Both upper and lower limbs Amputation level: R & L distal forearmTransplant Side: Bilateral forearm
800-DONORS-7 • core.org
THANK YOU!
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