Michigan Health & Hospital Association and Gift of Life Michigan
Welcome to the MHA Keystone: Gift of Life WebinarWednesday, September 19, 20121:00 pm – 2:00 pm
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Tissue 101: Exploring the Gift of Tissue
Introductions:• Ashley Renkes
Hospital Services Associate, Gift of Life Michigan
Questions:• Please type questions into the chat box• A question and answer session will take place at
1:45pm• If you prefer to pose your question anonymously,
please direct the chat to the “Host and Presenter” so that your question is sent only to them.
Today’s topic:
2012 Webinar Series Partnership between MHA and Gift of Life Michigan
Today’s speakers:
Ashley Renkes
Hospital Services Associate, Gift of Life Michigan
Betsy Miner-Swartz
Communications Specialist, Gift of Life Michigan
Gina Reese
Regional Director, Musculoskeletal Transplant Foundation
W E L C O M E !
What is tissue donation?
What can be donated?
When do hospitals refer tissue donors to Gift of Life?
How is the hospital involved in the tissue donation process?
How is Gift of Life working to increase tissue donations?
What happens to tissue after it leaves the donor hospital?
Questions to Run On…
Tissue 101:
An Overview of Tissue Donation
Ashley Renkes
Hospital Services Associate
Gift of Life Michigan
Gift of Life Michigan
Federally designated organ and tissue recovery organization for Michigan since 1971
Liaison between 175 critical-care hospitals and eight transplant centers
Independent, non-profit based in Ann Arbor
Maintains the confidential Michigan Organ Donor Registry in collaboration with the Secretary of State
Open 24/7/365
Tissue Donation
Tissues: Heart Valves Bone Arteries and Veins Corneas Ligaments & Tendons Fascia Nerves Skin
Some Interesting Facts…
There is no cost to families to donate. Funeral arrangements and open casket
funerals are not affected by donation. Most major religions approve of donation and
consider it an act of charity. Wealth and social status are not a factor in
receiving an organ or tissue transplant. People of all ages can become tissue donors. Tissue recovery can occur up to 24 hours after
death, 12 hours for corneas.
Facts about Tissue Donation
Last year (2011) in Michigan:
37,261 deaths were called in to Gift of Life by hospitals and medical examiners.
887 donors gave the gift of tissue.
1833 individuals donated corneas/eyes.
Human donor tissues were used at over 200 Michigan hospitals and surgical centers in over 750 different configurations.
Referral Process: Organ vs. Tissue
Referring a potential ORGAN donor:
Call Gift of Life within 1 hour when: Vented patient with a GCS of 5 or less Vented patient being evaluated for brain death Vented patient being considered for withdrawal of
treatment or change in resuscitation status
Gift of Life approaches family at the hospital.
Referral Process: Organ vs. Tissue
Referring a potential TISSUE donor:
Call Gift of Life within 1 hour of death: All hospital deaths are referred to Gift of Life for
evaluation Many non-hospital deaths are reported by Medical
Examiner Offices
A specially trained Designated Requestor from
Gift of Life Michigan approaches the family over the phone.
Gift of Life refers all patients to the Michigan Eye bank. If a patient is only eligible to donate corneas, you will receive a
follow-up phone call from the Michigan Eye Bank to coordinate the recovery.
Eye Prep Protocol to maintain corneal integrity, complete after family departs: Instill two drops of sterile saline into each eye. Paper tape the eyes closed. Elevate the head (pillow or head block). Cool the eye region. Recovery must occur within 12 hours of death. The Michigan Eye-Bank may call you back for more
information.
Michigan Eye Bank and Donation
Before After
Cornea Donation Restores Sight
Referral Process
Gift of Life receives a referral from a hospital, ME or funeral home about an individual that died.
Donor eligibility is determined by Gift of Life based on basic criteria and available information.
The state donor registry is searched and family is contacted for a medical and social history.
Referral Process
If the donor is not found on the registry, the legal next of kin is given the opportunity to authorize the donation.
Tissue donation must be initiated within 24 hours of death, 12 hours for corneas.
Please Remember:
Age and medical rule-out criteria change often based on tissue needs.
All of the information Gift of Life collects is required by the Food and Drug Administration (FDA) and our tissue bank partners before we move forward with a donation. This ensures the safety of technicians and recipients.
Gift of Life coordinates the time and location of the tissue recovery with the Medical Examiner, if appropriate.
Tissue donations happen in the hospital or at one of Gift of Life’s surgical centers.
Call us if you have questions during the donation process!
Hospital’s Responsibility
Report all deaths to Gift of Life within 1 hour.
Obtain (2) phone numbers where the family can be reached.
Refrain from discussing donation with the family – only trained designated requestors may do this.
Hospital’s Responsibility
If the family asks about donation, call Gift of Life immediately. Sometimes the donation discussion occurs over the phone with a Gift of Life requestor before the family leaves the hospital.
After the initial referral, be prepared to provide additional information about the patient from their medical chart to help facilitate the donation.
Gift of Life Michigan’s Responsibility
Ensure families are approached in a sensitive manner by a trained professional.
Provide complete and accurate information when obtaining authorization.
Abide by all FDA and American Association of Tissue Bank (AATB) standards when recovering and placing tissue.
Gift of Life Michigan’s Responsibility
Do everything possible to honor the wishes of individuals on the Michigan Donor Registry.
Ensure that families of potential donors are given the option to donate if their loved one is a candidate.
Work with Medical Examiners and funeral homes to facilitate tissue and eye donation.
Recovery and Post-recovery…
Tissue recovery is surgical procedure done by trained technicians in a sterile or aseptic environment.
Once tissues have been recovered, appropriate reconstruction occurs to ensure a natural appearance for the funeral.
Gift of Life Michigan is committed to treating all donors with the utmost dignity and respect.
Increasing Tissue Donation in Michigan
Betsy Miner-Swartz
Communications Specialist
Gift of Life Michigan
Growth in Tissue Donation
Medical examiner cases have contributed greatly to tissue donation in 2012 for three reasons:
• Increased outreach to MEs and positive reinforcement to those willing to make referrals.
• New computer technology allows participating counties to make referrals quickly and easily.
• New medical examiner newsletter with statewide map
motivates MEs.
Newsletter Tracks ME Performance in Donation
Winter 2011 Summer 2012
The Map
Most Significant Changes Highlighted
The map page lists counties that made the most significant change in their map status.
Here are some entries from Summer 2012:
• Macomb County went from 0 to 77 referrals, resulting in 8 tissue donors.
• Genesee County went from 103 to 165 referrals.
• Bay, Iron and Macomb counties had first-time referrals.
Thank You for Making a Difference
The newsletter also recognizes ME offices that put forth a special effort to make tissue and eye donation possible.
Here are a few examples from the Summer 2012 edition:
• Marquette County released a potential donor for tissue recovery before
the autopsy because time limits were about to expire.
• Wayne County extended its release time and postponed an autopsy to
help with the logistics of a tissue recovery.
• In Lapeer County, Dr. Jason Parks has consistently shown extreme willingness to be available to Gift of Life tissue screeners for additional information.
Tissue Donation Overview
Gift of Life Michigan Michigan Hospital Association
Gina ReeseRegional Director
Musculoskeletal Transplant Foundation
My Plan Today
Who is MTF
Tissue Transplantation
Donor Families
MTF’s Mission Statement
MTF is a non-profit service organization dedicated to excellence in research,
education and the care of donors, their families and recipients.
MTF’s Structure501 (c) 3 non-profit founded in 1987Largest Tissue Bank in the U.S.Physician Driven5+ M allografts distributedEstimated 30% of all allograft in the U.S. provided
by MTFMajority of tissue from Organ Procurement
Organizations90,000 Tissue Donors since 1987In Michigan since 1987
Local AffiliationsGift of Life: Recovery Member
Since 1987Rich Pietroski, Member of Donation Board of
Trustees and Medical Board of TrusteesHenry Ford Hospital: Academic Member
Stephen Bartol, MD – Medical Board of Trustees Member
Tissue Grafts in Michigan: 15,583 in 2011
Tissue Donation Basics
Tissue = catch all phrase for musculoskeletal, cardiovascular and skin
Recovery only after Cardiac Death (Cessation of heart beat)
Number of potential donors limited only by donor criteria
May be organ and/or cornea donors as wellFDA OversightMTF and Gift of Life both AATB Accredited
MTF and Gift of LifePartners in screening and recoveryMTF accepts donors before recoveryMTF one of the few aseptic tissue processors
Thorough screening = safe and effective tissue grafts
Maintain the biological function of the tissueBetter outcomes for patients
U.S. Statistics100% of OPOs are involved with tissue donor
referrals93% of OPOs are involved with tissue recovery
(54/58)Recovery Rates
25,000 to 30,000 Tissue DonorsTissue Transplants (bone, skin, CV)
1.7M/Year85% MS TissuesMTF: 492,000 in 2011
General Orthopedic Tissues
Sports Medicine Tissues
MeniscusOsteochondral Graft (Cartilage)
Bone-Tendon-Bone
Achilles Tendon
Demineralized Bone Matrix (DBX®)
Trinity Evolution: Native Stem Cells, Cancellous Chips & DBM
Clinical ApplicationsSpinal Fusion Sports Medicine (ACLs)Bone Void Fillers – Trauma, Joint
ReconstructionOrthopaedic OncologySkin for BurnsAcellular Dermis for Ventral Hernia, Breast
Reconstruction post MastectomyHeart Valve/Vein Replacement
Supporting Donor FamiliesDonor Families are at the heart of what we all doTake our responsibility very seriously to be good
stewards of a family’s giftMake information available to donor families
Tissue Trace: Information card sent back by hospitalLinking Lives Program: Information directly from
recipients Insert in the package of each tissue graft Instructions on how a recipient can write a thank you letter
to the donor family Very successful: Over 10,000 letters received since start of
program
Thank you…Thank you for your support of donation
You’ve made a huge difference in the lives of donor families and recipients
We couldn’t do it with you!
Donor Family Follow Up
Organ and Tissue Donation Certificate of Honor Donor Family Ceremony Donor Quilt Grief Resources Communication with Recipients Donor Family Advisory Board
Join the Michigan Donor Registry
If you don’t have a red heart emblem on your driver’s license or state ID, you’re not registered.
Go to www.giftoflifemichigan.orgor call 800.482.4881 Michigan StatutesMichigan Statutes
2003 Bill # 4479 – First Person Consent• An anatomical gift made by a will or a document of gift (i.e.
donor registry) is not revocable after the death of the donor, making the donor’s wishes paramount.
• State ID cards and driver licenses are acceptable documents authorizing an anatomical gift.
• A heart now appears above the driver’s license picture for those registered since January 1, 2007. Prior registrations or other documents of gift signed at any time are still valid
Please inform your family of your wishes regarding donation.
Resources
Gift of Life Michiganwww.giftoflifemichigan.org
Michigan Health & Hospital Associationwww.mha.org
Musculoskeletal Transplant Foundation (MTF)www.mtf.org
Question & Answer Session
•Ashley Renkes (Moderator)Hospital Services Associate, Gift of Life Michigan
To ask a question…
•Please type questions into the chat box
•If you prefer to pose your question anonymously, please direct the chat to the “Host and Presenter” so that your question is sent only to them.
Evaluation
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For additional information contact:
Ashley Renkes
Hospital Services Associate
Gift of Life Michigan
Thank You for Joining Us!