There are two different types of organ donation in Australia: living donation and deceased donation. Being a living donor usually involves donating a kidney or partial liver to a relative or close friend in need. While being a deceased donor refers to the donation of vital organs or tissues after you have died. This is the more common form of organ donation and the one we’ll be talking about in depth in this blog post.
Deceased organ donation involves removing organs from someone’s body after they have died to give a seriously ill or dying person a chance to survive. The person who receives the organ transplant is known as the ‘recipient’. In Australia you have to register to become an organ donor but even after registering, it is ultimately your family who decides what happens to your body after you die.
It is also possible to donate your body to science to help with medical research or training. However, you can’t choose to do both. If you have opted to donate an organ your body will become ineligible for scientific research. If you want to donate your body to science you will need to register with a specific university or medical institution as there is no overarching body which manages body donations.
The following organs can be donated after you die:
While the following tissue can be donated:
Parts of the eye.
To become an organ donor you need to register with the Australian Organ Donor Register. This can be done online in less than a minute by filling out a form with your name, date or birth, email address and your Medicare number. You can also register through your existing MyGov account, through the Express Plus Medicare App or by printing out and filling out a physical form and posting it back to the Services Australia office in Hobart.
If you are opposed to organ donation it is just as important for you to register this preference in the same way. When you die unless there is evidence you have changed your mind, family members are unable to give consent for you to become an organ or tissue donor under the Human Tissue Act 1983.
Once you register your interest it is essential you have a conversation with your loved ones, telling them about your intentions. When you die it will be your next of kin who will need to give consent for such an important decision. This conversation will have the biggest impact on whether or not your wishes are fulfilled.
Organ donation is regulated under the ‘Human Tissue Act’ in each Australian state or territory. The legislation is partnered with an ethical framework guided by the National Health and Medical council.
Regulations are similar across the country, and operate under an informed consent, or ‘opt-in’ model. This means, the individual must have given written approval to register as an organ donor before they die. The family will always be asked to confirm the decision before a transplant takes place.
The Ethical Practice Guidelines include the following principles:
Donation of organs and tissues is an act of altruism and human solidarity (e.g it is done on a voluntary basis for the benefit of other human beings);
Organ transplantation should only be undertaken when it is believed that it provides a benefit to the recipient;
The method of transplantation should respect human dignity, the wishes of the deceased and give precedence to donor’s needs and their family’s needs over the interest of the recipient;
The process for determining someone’s eligibility to receive an organ donation should be equitable and fair; and
The decision not to donate should be respected and adhered to.
Additionally, organ donation can only take place if you die in a hospital. This is because in order for the procedure to be possible the person needs to have been artificially ventilated for their organs to be suitable for transplantation. The two situations where organ donation is possible are:
Brain death (when the brain stops functioning); or
Circulatory death (also known as DCD).
Brain death occurs when blood and oxygen stops flowing to the brain in the case of a stroke, or some kind of brain injury. Circulatory death usually occurs when doctors stop life-saving treatment for someone in an intensive care unit or emergency department. In this situation, donation can only go ahead if the person dies within 90 minutes of their treatment being stopped.
Almost anyone can donate organs and tissues in Australia. While age and medical history does play a part in eligibility for organ donation there are very few medical conditions which prevent organ donation. To be able to register to be an organ or tissue donor you must be 16 years or older.
One limitation is around people who lived in the United Kingdom while ‘Mad Cow Disease’ was prevalent. These people are still eligible for organ donation but they can’t donate tissue. If you have a transmissible disease like HIV, actively spreading cancer, or severe infections you may not be eligible. This is because there is a substantial risk the infection or virus could spread to the transplant recipient.
However, it is ultimately up to the medical professionals to determine whether or not your organs are suitable for donation. If you have registered for organ donation but die of cancer there may still be tissues including your skin, tendons, parts of your eyes and bones which can be used. Doctors will take a biopsy of the body at the time of death to make sure there is no risk to the transplant recipient as a result of the organ or tissue donation.