Organ and tissue donations are medical processes that save and transform lives. Organs and tissues are removed from a donor and transplanted into someone who is very ill or dying from organ failure or into one of the many Australians whose lives are transformed through eye and tissue donations. Australia has one of the highest transplant success rates in the world and research shows that the majority of Australians support organ and tissue donation.
Organ and tissue donation is important
One organ and tissue donor can save the lives of up to 10 people and significantly improve the lives of many more.
At any one time, there are almost 1,700 Australians waiting for a transplant on the official waiting list. Many people die each year waiting for the gift of a transplant. Some spend weeks or months in hospital, while others make several trips to hospital every week for dialysis or other treatment. Some people need to use an oxygen tank for 24 hours a day while they wait.
Organ and tissue transplants are needed
People who need an organ transplant are usually very ill or dying, because one or more of their own organs is failing. They range from babies and children through to older people. People needing a tissue transplant can be of any age. In some cases, tissue transplantation can save lives. More often, it greatly improves the recipient’s life.
Becoming an organ or tissue donor
Almost everyone can donate organs and tissues – there is no age limit on the donation of some organs and tissues. The determining factors are where and how a person dies and the condition of their organs and tissue. While your age and medical history will be considered, you shouldn’t assume you’re too young, too old or not healthy enough to become a donor.
You can decide to donate specific organs or tissues, with complete choice over which organs and/or tissues you wish to donate. Donation can involve:
- Organs – including kidneys, heart, lungs, liver, intestines and pancreas
- Tissues – including heart valves and tissues, bone and tendons, skin, and eye tissue.
The Australian Organ Donor Register
The Australian Organ Donor Register is the official national register for people 16 years of age or older who want to donate. At the Australian Organ Donor Register, you can record your decision about becoming a donor of organs and tissues for transplantation after death. This ensures that authorised healthcare professionals anywhere in Australia can check your donation decision 24 hours a day, seven days a week. In the event of your death, information about your decision can be provided to your family.
Even if you have previously expressed an intention to donate organs and/or tissues (for example, by ticking a box on your driver’s licence renewal), it’s very important that you record your decision on the Australian Organ Donor Register.
You can register your donation decision by either:
- Going to the Australian Organ Donor Register and registering online
- Calling the Australian Organ Donor Register to ask for a registration form to be mailed to you
- Visiting your local Medicare office and completing a registration form.
If you don’t want to become an organ and tissue donor, you can also register your decision not to donate on the Australian Organ Donor Register.
DonateLife supports organ and tissue donations
DonateLife is a network of doctors, nurses, organ donor coordinators, family support workers and other professional staff funded and led by the Australian Organ and Tissue Donation and Transplantation Authority. This network is responsible for identifying potential organ and tissue donors in Australian hospitals, providing information and support to families, facilitating donation and liaising with transplantation programs.
DonateLife in Victoria also works to educate and raise awareness of organ and tissue donation in the community, supported by a strong network of active volunteers. It provides information about organ and tissue donation, including resources, fact sheets and stories from donor families and transplant recipients.
Family decisions about organ and tissue donation
When a person dies in a situation where they can become an organ and tissue donor, the intensive care medical team raises the possibility of donation with the family. At this time the Australian Organ Donor Register is checked to support discussions between the medical staff and the family.
The family of a potential donor is given time to discuss and finalise the decision of whether donation will occur for their loved one. If the family agrees to the donation, a DonateLife coordinator will meet with them to discuss the donation in more detail and to complete the documentation to confirm donation.
All hospitals have a quality control process for donations. This means a staff member not involved in the clinical process must give authority for donation to proceed following family consent. This part of the process may also involve the state coroner if the circumstances of the person’s death are to be investigated by the coroner.
After the organs and tissues have been donated, the DonateLife coordinator stays in touch with the donor’s family and keeps them informed about the progress of the transplant(s) and provides support for them during their time of grief.
Specialised medical teams perform all donations and transplants in the Australian public and private health systems. The removal of organs and tissues is no different to any other surgical procedure. The donor’s body is always treated with dignity and respect. The donation of organs or tissue doesn’t alter the physical appearance of the body or affect funeral arrangements.
Organ and tissue allocation
Australia has strict ethical guidelines about the allocation of organs and tissue. Allocation depends on a ‘match’ between the donor and the people on the waiting lists. The process also considers the urgency with which a particular person may need a transplant and the length of time they have been on the official waiting list for transplantation.
A person’s race, gender or status is not taken into consideration.
Timing of an organ donation
Organs can be donated when a person has been declared brain dead in an intensive care unit in hospital. Brain death is when the blood circulation to the brain ceases and the brain stops functioning and dies with no possibility of recovery. A series of tests carried out by two independent and appropriately qualified senior doctors establishes that brain death has occurred. Less than two per cent of all people who die in hospital each year die in this way.
People can be confused about the difference between brain death and being in a coma. A person in a coma is unconscious because their brain is injured in some way. However, their brain continues to function and may heal. With brain death, there is no possibility whatsoever that the brain will recover. Medical tests clearly distinguish between brain death and being in a coma.
Organ donation may also be possible after a person’s heart has stopped beating, referred to as cardiac death, but this is less common.
Timing of tissue donations
A far greater number of people have the opportunity to donate tissue for transplantation. For tissue transplantation to be successful, tissue donation doesn’t require the donor’s death to have occurred under the same limited circumstances as required for organ donation. Unlike organs, tissue may be stored for a period of time.
Telling your family about your donation decision
The people close to you – your next of kin – need to know your donation decision. In the event of your death, they will be asked to confirm your donation wishes. In Australia, family consent is always sought before donation can proceed – even if you are listed on the Australian Organ Donor Register.
Knowing the wishes of loved one is the most important factor that helps families to decide. Families that have discussed and know each other’s donation decisions are much more likely to uphold those decisions.
When to discuss organ donation with your family
Try to use everyday situations to start a discussion about important life issues, including what to do with your organs and tissues in the event of your death. A practical guide to assist families to have an informed and memorable family discussion is available from DonateLife.
Some suggested situations to discuss your donation decision with your family could include:
- The next time your family sits down together for a meal
- When you leave home for the first time as a young adult
- When you obtain or renew your driver’s licence
- When you celebrate an anniversary with your partner
- On a significant birthday
- When you hear about someone who has been a donor, needs a transplant or has had one
- When you watch donation and transplant stories on TV or see an article in the media
- When you see or hear an advertisement about organ and tissue donation
- After a friend or family member dies
- When children discuss the topic at school.
If you have already discussed your wishes with your family, these events provide a good opportunity to repeat your wishes to ensure they are remembered.
Topics to discuss about organ and tissue donation
Everyone has their own reasons for becoming an organ and tissue donor. It’s important your family, partner and friends understand your reasons and that you understand theirs.
Some potential discussion topics could include:
- Your own reasons for wanting to donate
- The facts about donation
- Myths and misconceptions people have about donation
- Stories about donor families and transplant recipients (available on the DonateLife website)
- Whether there’s any organ or tissue that you don’t want to donate
- Family member views on organ and tissue donation.
It’s important that your family remembers the donation discussion, so if they are ever faced with having to make the decision, they immediately know your wishes. It’s also important you know the wishes of your family members.
Where to get help
- DonateLife Victoria Tel. 1300 133 050
- The Australian Organ Donor Register Tel. 1800 777 203
- Your doctor
Things to remember
- Discover the facts about organ and tissue donation, decide about becoming a donor and discuss your decision with the people close to you.
- Join the Australian Organ Donor Register to ensure your wish to donate is known, recorded and able to be noted by authorised medical personnel.
- You will be declared brain dead or your heart will have stopped beating (cardiac death) before your organs or tissues are retrieved.