Stages of organ donation after brain death

Provided by : Javad Eynaki Maleki

Organ donation after brain death or cardiac death (typical death)

With the consent of the parents, all those who have suffered from brain death or cardiac death (normal death) can have their organs removed and transplanted into patients.  All over the world, a few decades ago, brain death was considered equivalent to definite death, and in our country, according to the law (approved in 1379), brain death is equivalent to death.  According to the same law, organs are allowed to be removed from cases of brain death as well as cardiac death with the consent of the family and its transplantation.

Organ donation after brain death:

The main human organs such as the heart, lungs, liver, kidney ... due to having the main blood vessels are destroyed as soon as they die.  Therefore, these organs can only be removed from cases of brain death, and after removal, they can be stored for a short time and must be transplanted immediately.  The donor should not have AIDS, hepatitis or cancer and should not be older than 60 years.

Organ donation after cardiac death:

Tissues such as bones, heart valves, tendons, corneas, etc. live longer and can be removed after normal death (cardiac death) and can be stored for years.  Therefore, in cases of death (cardiac death), if the person does not have an infectious disease and timely information and consent is given, the tissue can be removed.  The donor should not have AIDS, hepatitis or cancer and should not be older than 60 years.

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Difference between brain death and coma:

Brain death is a state that the brain goes away and dies, but because the spinal cord is alive, the rest of the members  (such as the heart) remain alive for a few days; In this case, the person's breathing is discontinued and there is no medical reflection of the individual's improvement or alive, and as soon as the devices are disconnected and the person dies, and with the device and medical care, there are only a few days of "vegetative state" for the individual.

Brain death differs with anesthesia or coma, and most of the accidents occur. To confirm brain death in Iran, they will keep watching 24 hours, and after a variety of experiments and approval of the six specialist appointed by the Minister and Forensic Medicine, and the work of transplantation should be done only in government universities.

Transplant recipients:

Transplant recipients are placed on the waiting list based on blood group, intensity of need and waiting time, and at the same time as the family consent of the deceased for organ donation, a number of transplant recipients will be examined in terms of size and weight and tissue matching tests to make the organ the most suitable person.

Transplant cost:

For a member or tissue, there is no way to pay a donor or receive a recipient, but it is costing for surgical procedures and member maintenance and experiments that are covered by insurance, and the government is paying most costs.

In the operation of organ harvesting from the deceased, the body is not mutated and replaced with the harvested prosthetic organ so that the shape of the body does not change.

Having a member card donor and written will is not enough! Family satisfaction is required:

It is imperative that even if the family consent, in the event of membership in this plan or written will, fails to prevent this. So, in order to ensure that this heart desire is made, keep your relatives from having a donated card and this benevolent decision.

Persian page link : https://ehda-zendeghi.blogsky.com

Translator : Javad Eynaki Maleki

Thousands need organ transplantation in Iran

Image of transplantable organs and tissues after brain death

 The head of the Department of Transplantation and Special Diseases of the Ministry of Health said (quoted in October 2015): There are 27,000 patients in need of organs in Iran, 7 to 10 of whom die every day due to lack of proper organ transplantation.

According to Mehr news agency, Dr. Katayoun Najafizadeh, on the sidelines of the 12th Celebration of The Breath in Milad Tower in Tehran, said: "Between 5,000 and 8,000 people die annually in Iran with brain death, half of whom have donated organs.

He lamented that only about 700 people out of 2500 to 4 thousand cases of donation brain death donate their organs, said: There are 27 thousand patients in need of organs in Iran, 7 to 10 of them daily due to lack of proper organs The  transplant member dies.

Najafizadeh added: "The most important reason for the lack of transplant organs is the dissatisfaction of families with organ donation due to the lack of public awareness of the nature of brain death and organ donation."

He said: "In brain death, brain cells are destroyed and brain tissue is transformed into a pasty substance that is irreparable and reversible.

Najafizadeh stated that the confirmation of brain death is only the responsibility of four groups of trained and trusted physicians of the Ministry of Health in the specialties of neurosurgery, neurology, internal medicine and anesthesia, said: Each person with brain death can save eight people from certain death by donating one to eight vital organs (heart, liver, two lungs, two kidneys, pancreas and intestine) and by donating one to 53 tissues It can save one to 53 people from disability.

He added: "Currently, the only national and governmental site for the immediate issuance of an organ donation card is ehda.ir, which immediately after entering the applicant's information, the organ donation card appears and is available."

Najafizadeh stated that transplant patients need more help in receiving medicines after transplantation, price, insurance and availability, and called for more attention of authorities to such patients.

Source: http://salamat.life

Persian page link :https://ehda-zendeghi.blogsky.com

Thank you for trying to save a human life

Translator : Javad Eynaki Maleki

Stages of organ donation after brain death

Identification stage

Identification methods include:

A: Transplant communicators: In each hospital, a person, usually the head nurse or one of the ICU staff, who is selected in coordination with the hospital director, notifies the unit if the patient has brain death.

B: Continuous contact made by the coordinator in the form of telephone calls to all hospitals covered every two days

C: Intermittent rebellion by coordinators in the form of intrusive visits to covered hospitals is usually performed every 2 weeks.

Initial visit stage:

After being informed of the presence of brain death patient, the coordinator of the provision unit will be dispatched to the hospital of origin. In the relevant hospital, the initial visit is made (some patients are removed in the initial examination) if the brain death is confirmed in the initial examination, then the initial E-tape is taken from the patient and the forms are filled out by the coordinator.

Transfer consent:

If the family consents to organ donation, the transfer consent form is signed by the patient's companions and the patient is discharged by his family.

 Find recipient step:

After this stage, while contacting the ministry, the recipient will be able to find work based on blood type and size, the general condition of the recipients and their turn in the waiting list and tissue matching.

Transfer stage:

After completing the consent form and carrying out the discharge process and after the necessary coordination, the equipped ambulance will be sent to the hospital of origin along with the anesthesiologist and unit coordinator and the donor will be transferred to Dr. Masih Daneshvari Hospital.

Maintenance stage:

After being transferred to Dr. Masih Daneshvari Hospital, the donor is transferred to the ICU and the patient's condition is stabilized by anesthesiologists and the care process begins. During the maintenance phase, an anesthesiologist and one of the coordinators and a highly qualified nurse constantly control the patient's condition.

Confirmation of brain death:

At this stage, neurosurgery, neurologists, internal medicine and anesthesiologists are invited separately to visit the patient and confirm or deny brain death in the donor. These specialists are chosen directly from the ministry without single intervention.

The stage of obtaining Harvest's consent:

After confirmation of brain death by all four persons of the brain death confirmation group, forensic specialists visit the patient and after final confirmation of brain death, a briefing will be held at the site of the transplant unit in the presence of organ donor, aid worker, psychologist, forensic representative, coordinators and donor family, and while justifying the family, final consent for organ donation will be obtained from them.

Coordination stage:

In this stage, coordination with different teams across the country and operating room officials and personnel about the time of operation and the next steps is done.

Harvest Stage:

At this stage, the patient will be taken to the operating room and delivered to the present team in the operating room. Members are removed. And at the end of the operation, the site of the operation is well restored by one of the surgeons and the patient delivers the morgue.

The transfer stage of the deceased:

At this stage, after the discharge process by the provision unit, the forensic ambulance will be notified by the unit for transfer to the forensics or burial place.

Appreciation stage and participation in the funeral:

At this stage, the coordinator of the collection unit with a special appreciation letter and a large bouquet of flowers attends the donor's funeral and, while appreciating the family, if the conditions allow him to read the text of the commendation behind the speaker.

The Writing Stage of the Harvest Report

After each harvest, the report of how to do it in all details is written by the organ donor.

Thank you for trying to save a human life

Persian page link :https://ehda-zendeghi.blogsky.com

Translator : Javad Eynaki Maleki

تاریخچه و اهمیت کارت اهدای عضو

کارت اهدای عضو یکی از بزرگترین نمادهای فرهنگی در زمینه ارتقای فرهنگ اهدای عضو می باشد.

از زمان راه اندازی واحدهای فراهم آوری اعضای پیوندی در کشورمان، مراکز مختلفی شروع به ثبت نام و صدور کارت اهدای عضو نمودند. در روزها و ماه‌های اول تعداد ثبت نام به بیش از 100 نفر در ماه نمیرسید، اما با شروع تبلیغات فرهنگی و برگزاری جشن نفس، تعداد بیشتری از مردم نیک اندیش سرزمینمان با این امر مقدس آشنا شدند و تعداد افراد متقاضی کارت اهدای عضو به بیش از 500 نفر در روز رسید...تقاضای دریافت کارت اهدای عضو روز به روز بیشتر شد، به اندازه ای که مدت زمان دریافت کارت اهدای عضو برای هر فرد به بیش از 5ماه رسید. باتوجه به اینکه کارت اهدای عضو صرفاً نشان دهنده رضایت قلبی هر شخص برای اهدای عضو در زمان مرگ میباشد و جنبه‌‌ی قانونی ندارد؛ لذا بر آن شدیم تا سامانه ای راه اندازی کنیم که مدت زمان دریافت کارت را به طرز چشمگیری کاهش دهد تا انتظار رسیدن این کارت، مردم ایثارگر میهن عزیزمان را آزرده خاطر نسازد.با توجه به مسائل فوق و همچنین پیرو تاکید مقام محترم وزارت بهداشت، درمان و آموزش پزشکی، ابداع روشی برای ثبت نام و صدور آنی کارت اهدای عضو در دستور کار این وزارت قرار گرفت و نتیجه تمامی بررسی ها، سامانه ای است که پیش روی شما می باشد. در این سامانه کد ملی هر فرد به صورت آنلاین کنترل شده و در صورتیکه اطلاعات مطابق کارت ملی وارد شده باشد، کارت اهدای عضو صادر شده و متقاضی میتواند همان لحظه کارت خود را ذخیره و چاپ نماید.اطلاعات داوطلبین دریافت کارت بلافاصله وارد سامانه کشوری کارت اهدای عضو شده و در آن ذخیره می گردد. لازم به ذکر است این سامانه از طریق کلیه بیمارستانهای کشور قابل دسترسی بوده و امکان جستجوی نام افراد مرگ مغزی بستری در این بیمارستانها وجود دارد.امید است با راه اندازی این سامانه قدمی هرچند کوچک برای ارتقای فرهنگ مقدس اهدی عضو و نجات جان بیماران نیازمند به پیوند اعضا برداریم...لطفا به نکات زیر توجه داشته باشید:
- عزیزانی که برای دریافت کارت اهدای عضو از طریق سامانه ehda.ir  یا سامانه های مشابه ثبت نام کرده اند، توجه داشته باشند که جهت پیگیری کارت خود لازم است به همان سامانه مراجعه کنند.
- داوطلبانی که در سامانه های دیگر ثبت نام نموده و از طریق این سامانه ها و یا از طریق مراجعه به هر یک از واحد های فراهم آوری کشور یا ارگانهای دیگر کارت دریافت نموده اند همچنین می توانند برای ثبت اطلاعات خود در سامانه www.ehdacenter.ir نیز اقدام نمایند تا اطلاعات آنها در سامانه مرکزی نیز ثبت شده و از تمام کشور قابل دسترسی باشد. .
- در صورتیکه علاوه بر ثبت اطلاعات تان در سامانه مرکزی اهدای عضو تمایل دارید کارت اهدای عضو را نیز دریافت نمائید، می توانید کارت خود را بلافاصله پس از تکمیل اطلاعات پرینت گرفته و کارت پرینت شده را پرس کرده و استفاده نمایید.
-درصورتی که قبلاً در این سامانه ثبت نام کرده اید، جهت ویرایش اطلاعات شخصی و یا چاپ مجدد کارت خود برروی دکمه ورود به سامانه کلیک نمائید، در غیر اینصورت جهت ثبت نام و دریافت کارت اهدای عضو خود برروی دکمه ثبت نام کارت اهدای عضو کلیک کنید.

History and importance of organ donation card

Organ donation card is one of the biggest cultural symbols in promoting organ donation culture

Since the establishment of transplant donation units in our country, various centers have started to register and issue donation cards.  In the first days and months, the number of registrations did not reach more than 100 people per month, but with the beginning of cultural propaganda and celebrations, more and more benevolent people of our country became acquainted with this sacred thing and the number of people applying for organ donation cards Reached 500 people per a day.

The demand for organ donation cards increased day by day, so much so that the period of receiving organ donation cards for each person reached more than 5 months.  Considering that the organ donation card only shows the heartfelt consent of each person to donate an organ at the time of death and has no legal aspect; Therefore, we decided to launch a system that significantly reduces the time it takes to receive the card so that waiting for the card to arrive does not bother the self-sacrificing people of our beloved homeland.

According to the above issues and also following the emphasis of the ministry of health and medical education, the invention of a method for registering and issuing organ donation cards instantly was on the agenda of the ministry and the result of all the reviews is the system that is ahead of you. In this system, each person's national code is controlled online and if the information is entered in accordance with the national card, the organ donation card is issued and the applicant can store and print his/her card at the same time.

The information of the volunteers for receiving the card is immediately logged into the national organ donation card system and stored in it. It should be noted that this system is accessible through all hospitals in the country and it is possible to search for the names of brain death patients hospitalized in these hospitals.

We hope that by launching this system, we will take a small step to promote the sacred culture of organ donation and save the lives of patients in need of organ transplants.

Please note the following points

     Dear ones who have registered to receive an organ donation card through ehda.ir system or similar systems, note that they need to refer to the same system to follow up their card

    Candidates who have registered in other systems and have received a card through these systems or by referring to any of the supply units of the country or other organs, can also register their information in the system www.ehdacenter.ir to take action so that their information is registered in the central system and is accessible from all over the country

    If you want to receive an organ donation card in addition to registering your information in the central organ donation system, you can take your card immediately after completing the printed information and press and use the printed card

   If you have already registered in this system, click on the login button to edit your personal information or reprint your card, otherwise click on the organ donation card registration button to register and receive your organ donation card.

Source: https://ehdacenter.ir

Translator : Javad Eynaki Maleki