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¶ … Corneal Donation within Hospitals and Medical Communities: Issues Surrounding Post Mortem Donations of Tissue
Qualitative Study Reduce limitations on organ transplantation and tissue donation could potentially improve the quality of lives of thousands of people annually. At present research suggests the wait time for donation is greater than 2 years. Identifying and subsequently proposing solutions to the barriers that currently exist to donation will not only improve the quality of life for patients, but also help strengthen bilateral ties between Australia and Malaysia as well as strengthen Australian education and research relations with Malaysia.
The purpose of this study is to identify barriers to corneal donation within hospitals and medical communities. A large body of research has focused on issues surrounding the post mortem donations of tissue. This research will take a different approach, examining what barriers exist within hospital and medical communities in an attempt to determine how these barriers may be overcome.
The number of potential corneal donors far surpasses the number of people available for traditional organ donations and in some states consent of the medical examiner alone is enough to allow use of corneal donations (family consent not required) (Lewin, 2000).
Traditionally the most significant barrier to organ donation and transplantation has been acquisition of organs and tissues (Murray et. al, 2002). The need for cornea tissue is rising. The average wait time for a corneal transplant is two or more years (Murray et. al, 2002). Typically patients with pain resulting from corneal disease and blindness in both eyes are considered priority patients (Murray, et. al, 2002). Thought there have been more corneas available, the wait time and list still remains long.
Significance of Research
Corneal Transplants qualify as cadaveric transplants, or organs donated from individuals clinically classified as dead (Lewin, 2000). There are many "taboos" surrounding such transplantations (Lewin, 2000), but these are usually significant only in the realm of the public. This attempts to contribute new research to the medical field by identifying the barriers that exist outside of the public realm, within hospitals and communities..
I am a Malaysian citizen, affiliated with Monash University, Malaysia. I am applying to undertake a research stint at the Corneal Eye Bank, Centre of Eye
Research Australia, located at the Department of Ophthalmology, University of Melbourne. As such my proposed area of study is transplantation of cultured corneal limbal stem cells.
Background/Literature Survey
Barriers that have already been identified in general with regard to organ transplantation include a shortage of donated organs; in 1990 approximately 16,945 individuals in the U.S. received cadaveric organ transplants (Lewin, 2000). More than 4,855 were still in need and of just under 6,000 deaths resulted in donations whereas potentially 15,000 qualified (Lewin, 2000).
Barriers to donation also include low rates of family consent and missed opportunities to "identify and refer potential donors" to organizations that would approach families (Lewin, 2000). Though Gallup surveys indicate that more than 85% of individuals support the cause of organ donations, less than 50% of families consent after death (Lewin, 2000). Requests are also sometimes not made to family members, which can present another barrier (Gortmaker, et. al, 1996; Lewin, 2000).
Barriers include lack of education among the public regarding corneal donation and education and training among medical, nursing and allied health professionals (Murray, et. al. 2002). Among the primary reasons for a transplant may include corneal failure after surgery, immunologic rejection of prior implant, hereditary or genetic corneal problems, scarring after disease or trauma (Murray et. al, 2002). Lack of Medical Suitability, age of donor and lack of consent are among the…
References
Gortmaker SL, Beasley CL, Brigham LE, Franz HG, Garrison RN, Lucas BA, Patterson RH, Sobol AM, Grenvik NA, Evanisko MJ. Organ donor potential and performance: size and nature of the organ donor shortfall. Crit Care Med 1996; 24(3):432-9.
Halloran, P.F. (2003). "Transmission of Donor Melanoma to Multiple Organ Transplant Recipients." American Journal of Transplantation, Vol. 4 Issue
Hawkins, B.R. (1993). "The HLA System and Transplantation Matching in the 1990s." Journal of the Hong Kong Medical Association, 45 (2): 77-86
Jensen, T.R. (2000). "Organ Procurement: Various Systems and Their Effectiveness." Houston Journal of International Law, Vol. 22, Issue 3.
Long, J., Walsh, D., Ritchie, D.A.W., & Russell, F. (2000). "Corneal Donation in the Accident and Emergency Department: An Observational Study." British Medical Journal, November. Available: http://www.findarticles.com/p/articles/mi_m0999/is_7271_321/ai_67708478
http://www.cdha.nshealth.ca/tranplantservices/YearEndReports/yearendreport.pdf
2009). The susceptibility is highest is the first month of the transplantation and decreases afterwards. it, however, remains high even after 12 following. Susceptibility is highest among kidney recipients who are more likely to develop the infection 12 months after the transplantation. They have a lower mortality rate than liver transplant recipients. The study also reflected a trend in increasing antimicrobial resistance among these susceptible recipients. The E-coli strain
Concern also focused on the imbalance of the trade because the market is for only those who can afford, therefore only gives chance for the well-off. The black market has been referred to as the transplant trade outside of the United States. Legalization of the international organ trade would lead to increased supply, lowering prices. Therefore the poor might be able to afford such organs as well. Bioethics is also
That is especially true because in the vast majority of cases, prospective organ donors are younger than their surviving family members since only organs from relatively young people are suitable for use as transplant organs. However, those family members who do provide consent to harvest their loved one's organs invariably come to regard that choice as something that gives meaning to the untimely deaths of their loved ones. In
The flaws have been reverted through the policy of no-give, no-take, "under this system in order to receive an organ the individual has to previously signed their organ donor card" (Alexander, 2004). The merit of such policy is that "it satisfies most people's moral intuitions, the people are comfortable with the morality of reciprocity, those who are willing to give should be the first to receive" (Alexander, 2004). In 2004,
However, these side effects are a small price to pay in light of the alternative, which is often a severely compromised quality of life and early death. The donor should consider several topics. There is no additional financial risk to being an organ donor. Furthermore, the body is not disfigured during organ removal; thus, open casket funerals are possible. Also, donated organs will be used for transplants into recipients
Organ Donation There is a space for a small pink sticker on everyone's driver's license which you choose to affix or to leave off of the identification. The sticker signifies that, should you be in a car accident and are declared to be brain-dead with no chance of recuperating, you agree to allow medical professionals to donate your organs to people who are in very dire need of them. When people