From Authorization to Allocation
Authorization for Donation
Authorization for donation is conducted with the legally authorized decision maker by an Iowa Donor Network representative. For registered donors, the donor’s registry status is shared with the family and a disclosure for donation is conducted with the legally authorized decision maker.
Donor Evaluation and Donor Risk Assessment Interview
Iowa Donor Network is responsible for determining the donation potential of every referred patient. Very few conditions rule out organ donation. Please do not assume a patient is not suitable to donate; let Iowa Donor Network make that determination.
A donor risk assessment interview is conducted with the authorized decision maker, family member, or someone who knew the donor well enough to answer questions pertaining to medical and behavioral history which are used to determine the risk of disease transmission to a recipient.
Donor Medical Management
Continued treatment or good patient care up until death is determined is key to preserving the opportunity of donation and maximizing the gift. Treating the patient will preserve the opportunity for donation for the patient and the patient’s family.
Remember – good patient care is good donor care. Refer to the Catastrophic Brain Injury Guidelines for further guidance.
Once a patient has been declared dead by neurological criteria and authorization for donation completed, Iowa Donor Network coordinators will initiate donor medical management. Goals of the donor management include:
- Maintain systolic blood pressure within acceptable parameters
- Maintain stroke volume variation (SVV) within acceptable parameters
- Maintain adequate oxygenation
- Replace electrolytes to within normal ranges
- Maintain adequate hydration
Once medical management has resulted in optimized organ function, the donor is registered with the United Network for Organ Sharing (UNOS), the organization responsible for managing the nation’s organ transplant system under contract with the federal government.
UNOS maintains the centralized computer network which holds the organ transplant waiting list, and links all organ procurement organizations and transplant centers. Specific donor characteristics such as age, height, weight, blood type, etc. are entered into this network and matched for compatible characteristics of registered recipients. IDN obtains the allocation list for each organ and makes electronic organ offers to transplant centers through UNOS.