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Intestinal Rehabilitation and Indications for Intestinal Transplant

  • How are organs matched and distributed?
    There is one national computerized list of every patient waiting for an organ from a deceased donor. When a donor becomes available, the computer identifies the best matched recipient for each organ the donor provides. Some factors considered in matching include compatible blood and tissue types; similar body size; severity of patient illness and time on waiting list; and distance between donor hospital and transplant hospital. Depending on the organ, specific matching factors will vary. For intestinal transplants, matches are mainly based on blood type and body size.
  • Can people of different ethnicities match?
    Absolutely yes! Organs are not matched according to race or ethnicity, and people of different races frequently match one another. However, a compatible blood type between the donor and recipient is essential for a successful transplant. Because certain blood and tissue types are more common among specific ethnicities, all individuals have a better chance of finding a match if there are large numbers of donors from all backgrounds.
  • How will the right donor be found for me?
    When a transplant hospital adds you to the waiting list, it is placed in a pool of names. When an organ donor becomes available, all the patients in the pool are compared to that donor. Factors such as medical urgency, time spent on the waiting list, organ size, blood type and genetic makeup are considered. The organ is offered to the candidate that is the best match.
  • The National Organ and Transplant Act (NOTA) of 1984
    This act established the basic institutional framework for organ recovery distribution and use in the United States. NOTA prohibited the sale of organs as well as created a network of organ procurement organizations (OPOs). The OPOs are required to be a part of the Organ Procurement Transplantation Network (OPTN), which is the entity created on the national level for coordination of the OPOs. The first OPTN contract was awarded to the United Network for Organ Sharing (UNOS) in 1986 and they have held the contract ever since.
  • What is the function of Organ Procurement Organizations (OPOs)?
    Each OPO is responsible for a defined geographic area known as a donation service area (DSA)- the United States is divided into 58 DSAs, so there are 58 OPOs. The OPOs are designated by the federal government to promote organ donation, identify potential donors, and recover and distribute recovered organs for transplantation into patients who require them. New allocation policies for liver and intestine as of February, 2020 has changed organ distribution based on DSAs to acuity circles. Find out more information here.
  • What is the function of the United Network for Organ Sharing (UNOS)?
    Manages the national transplant waiting list, matching donors to recipients. Maintains the database that contains all organ transplant data that occurs in the US (Organ Procurement and Transplantation Network). Monitors every organ match to ensure organ allocation policies are followed. The OPTN (which in the United States is contracted as UNOS) works hard to make sure that everyone who needs an organ will have an equal chance of getting a transplant. A patient’s chance to receive an organ is not affected by age, gender, ethnicity, religion, lifestyle, financial status, or social status. Many groups work together to make transplant possible, each group has a different job, and all members are involved in helping to make OPTN policies.
  • Who belongs to the OPTN?
    Transplant candidates Transplant recipients Family members of transplant candidates and recipients Family members of organ donors Living organ donors Nurses, social workers, surgeons, physicians and lab technicians who specialize in transplantation Members of the general public who have an active interest and involvement in donation/transplantation Transplant hospitals Organ procurement organizations Transplant organizations OPTN members work to make policies as fair as possible and the involvement of all members of the transplant community help to do this.
  • What is the Organ Donation Breakthrough Collaborative (ODBC)?
    This was an initiative started by the Secretary of Health and Human Services in 2003 with the aim to dramatically increase the availability of transplantable organs and provide best practices for organ recovery and placement. The collaborative worked to create systems to allow accurate and timely donor referral, screening, consent, organ recovery, and placement. The ODBC was institutionalized into the Donation and Transplantation Community of Practice (DTCP) and is coordinated by the Organ Donation and Transplant Alliance formed in 2006 to continue the efforts.
  • What is the Arbor Research Collaborative for Health?
    This is a nonprofit research organization established for the purpose of conducting major studies in epidemiology and public health. It is important to transplant because it is in charge of administering the Scientific Registry of Transplant Recipients (SRTR)- a national database of transplant statistics. The registry was founded in 1987, and exists to support ongoing evaluation of scientific and clinical status of solid organ transplant, including kidney, heart, liver, lung, intestine, and pancreas. Learn more about SRTR here.
  • Who can become a donor?
    Anyone and everyone! Your medical condition at the time of death will determine what organs and tissue can be donated. If you wish to register, please visit this site. It’s never too late to sign-up!
  • What organs and tissues can be donated?
    Organs that can be donated include: Heart 2 kidneys Pancreas 2 lungs Liver Intestines Tissues include: Corneas Skin Heart valves Islet cells Connective tissue (bones, tendons, cartilage, ligaments) Bone marrow Blood vessels Blood
  • What kinds of injuries may lead to brain death?
    Strokes Aneurysms Anoxia (lack of oxygen to the brain) Brain tumors Head trauma is a common condition that leads to brain death. Automobile accidents, falls, and direct blows to the head (including gunshot wounds) may result in severe brain injury and subsequent brain death.
  • How can you tell if someone is brain dead?
    A person who is brain dead does not exhibit certain reflexes that require the brain to function. For example, Their pupils do not react to light by constricting. They do not gag if a tongue depressor is placed in the back of their throat. There is no response to pain. Also, specialized medical tests may be done to further confirm brain death. This may include an electroencephalogram (EEG), which would show no electrical activity coming from the brain.
  • Will my decision to donate affect the quality of my medical care as a patient?
    NO. Your doctors will not even begin to consider organ and tissue donation until after all efforts have been made to save your life. The doctors who are working to save your life are entirely seperate from the transplant team.
  • Will donation interfere with having an open-casket funeral?
    NO! After the organ removal takes place in the operating room, surgeons will complete the surgery as usual and you will be able to proceed with an open casket funeral if you wish.
  • Does it cost anything to donate organs or tissues?
    No. Your family will not incur any costs associated with the donation.
  • Is there an age limit for donating organs?
    No. There is not a set age limit for organ and tissue donation. At the time of death the organs and tissues will be evaluated by the medical team to determine their suitability for donation.
  • Does my religion approve of donation?
    Yes! All major religions approve of donation and consider it a gift.
  • What medical conditions exclude a person from donating organs?
    The organs will be evaluated at the time of donation. In general, HIV and cancer normally will exclude an individual from donating organs. Those with other medical conditions are encouraged to sign-up for donating organs.
  • Can non-residents donate and receive organs in the US?
    Yes. Non-resident aliens—people who don't live in the U.S. or aren't citizens—can both donate and receive organs in the United States. Organs are given to patients according to medical need, not citizenship.
  • If I register as a donor, will my wishes be carried out?
    Yes. If you signed up as a deceased donor in your state registry and you are over 18, then you have legally authorized your donation and no one can overrule your consent. Signing a card isn't enough. If you are under 18, your parents or legal guardian must authorize donation.
  • If I am a member of the LGBT community am I able to donate my organs?
    Yes. Everyone is allowed to donate his or her organs. There are no exceptions to this rule. The medical team at the time of donation will determine the suitability of the organs for donation.

Three Main Types of Intestinal and Multivisceral Transplant

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