From Authorization to Allocation

From Autho­riza­tion to Allocation

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Autho­riza­tion for Donation

Iowa Donor Net­work is respon­si­ble for deter­min­ing the dona­tion poten­tial of every patient for which we are noti­fied. 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.

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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.

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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 the patient can give. 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

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Organ Allo­ca­tion

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.