Skip to 0 minutes and 6 secondsDonation can be broadly classified into two-- deceased donation and living donation. The deceased donation can be further subdivided into donation after brainstem death, or DBD; donation after circulatory death, or DCD; or tissue donation. In this video, we will explore the different types of donation and the criteria for each type. Donation after circulatory death is previously referred to as "donation after cardiac death," or "non-heart-beating donation." In this type of donation, organs will be retrieved from a patient whose death is diagnosed and confirmed using cardiorespiratory criteria. The introduction of DCD organ donation programmes has increased the number of organs available for transplant, as kidneys, liver, pancreas, lungs, and heart may all be donated in this way with good outcomes for the recipients.

Skip to 1 minute and 0 secondsThe DCD donation will be facilitated after death of a patient, following the planned withdrawal of treatment once the continuation of treatment is considered to be of no overall benefit to the patient. The rates of DCD donation in the UK has increased substantially over the years, from 288 donors in 2009 to 619 donors last year. This represents 39% of all deceased donors in the UK last year. Donation of the brainstem death is possible from patients whose death has been confirmed by following guidelines for diagnosis of death using neurological criteria. This was previously referred to as "heart beating donation." The organs donated from a patient whose death is confirmed using the neurological criteria remains superior.

Skip to 1 minute and 50 secondsThat means that there will be less need for dialysis and few biliary complications for the recipient. A donor who is declared dead by following the neurological criteria will be able to donate their kidneys, liver, pancreas, lungs, heart, small intestine, depending on the organ's suitability and its function. Tissue donation and transplantation has a dramatic effect on a patient's quality of life. And it occurs on a larger scale compared to organ donation. In the UK, there are over 450 multi-tissue donors and 2,500 eye donors every year, resulting in many thousands of transplants. Some of these transplants, such as cornea and heart valve transplantation, has been established for many decades and are reasonably well-understood by health professionals.

Skip to 2 minutes and 44 secondsOther types of tissue donation, such as bone, skin, tendons, femoral arteries, meniscus are relatively rare, but will result in occasionally lifesaving treatments for patients. Unlike organ donation, tissues can be retrieved many hours after death has taken place, meaning that the potential pool of tissue donors is far greater than that of solid organ donors. The selection criteria for tissue donors are much more stringent because of the rather difficult balance between the benefits and risks when compared with solid organ transplantation. A living donor is the person who donates one of their healthy kidneys to someone with kidney failure who needs a transplant. This could be a friend or a family member, or someone they do not already know.

Skip to 3 minutes and 30 secondsAs a living donor, a person can also donate part of their liver for transplantation. In the UK, living kidney transplant has been performed since 1960. And currently around 1,100 such operations are performed each year, with a very high success rate. A successful transplant from a living donor is one of the best treatment options available for many patients with end-stage kidney failure. Research has shown that patients who receive a kidney from a living donor has a better life expectancy than who receive one from a deceased donor. Living kidney donation allows the operation to be planned at the time that is convenient for the recipient, donor, and the clinical team.

Skip to 4 minutes and 12 secondsLiving donor liver transplants has now become an important part of many liver transplant programmes across the world. This is considered as a transplant procedure of choice in most Asian countries due to the lack of deceased donors in these areas. But this is less commonly undertaken in Western countries because of the great availability of deceased donors. This is especially true for the UK. Following a recent increase in deceased donor pool, living donor liver transplantation now accounts for only 7% of all liver transplants performed in the UK. And majority of these are performed in three liver transplant centres.

Types of donation

Broadly speaking, organ donation can be classified into two different types: Deceased Donation and Living Donation. Deceased Donation can be further subdivided into 3 types: Donation after Death by Neurological Criteria (DNC, previously referred to as donation after brainstem death, or DBD), Donation after Circulatory Death (DCD) and Tissue Donation.

In this video, Doctor Shibu Chacko explores the different types of donation and provides an overview of the criteria required for each type. We have also included the slides used in this presentation as a PDF in the downloads section below.

Want to find out more?

The 7th Edition of the Guide to the quality and safety of organs for transplantation collates updated information to provide professionals identifying organ donors, transplant co-ordinators managing the donation process and transplant physicians responsible for organ allocation and utilisation with a useful overview of the most recent advancements in the field. This guide is intended to provide easy-to-use information and guidance to all professionals involved in donation and transplantation of organs so as to maximise their quality and to minimise risks and, thereby, improve the success rate of transplants.

The guide to the quality and safety of tissues and cells for human application has updated information for the professionals with a useful overview of the most recent advances in the field as well as technical guidance on ensuring the safety and quality of human tissues and cells applied to patients.

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This video is from the free online course:

Organ Donation: The Essentials for Healthcare Professionals

St George's, University of London