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Andrea has become captivated in the world of photography, recording the special moments in the lives of others. Her passion was inspired by the gifts of a kidney donation from her mother and the generosity of a pancreas from a stranger. |
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1. What is Gift of Life?
Gift of Life, the Michigan organ and tissue donation program, is a nonprofit (501c (3)), independent corporation certified by Medicare and designated by the Centers for Medicare and Medicaid Services as an organ recovery organization for Michigan . It was incorporated in 1971 by transplant surgeons in Michigan in order to have a central coordination network for the sharing of kidneys. As transplant surgery was developed for other organs, Gift of Life also became responsible to recover those organs as well. Gift of Life maintains an affiliate relationship with the Gift of Life Foundation. The latter is a nonprofit membership corporation of health care professionals and interested parties which functions as a supporting philanthropic and educational foundation to Gift of Life.
2. How is Gift of Life organized and structured?
A Board of Directors governs Gift of Life, making all policies and reviewing all activity of the organization at its regular meetings. There are 13 committees that address issues of histocompatibility, organ donation, multiple organ retrieval, preservation, etc. All transplant centers are represented in this structure, resulting in a patient-oriented program. Gift of Life also has a multi-disciplinary Advisory Board consisting of 45 health care and lay members. The day-to-day operations of Gift of Life are managed by an Executive Director.
3. What is Gift of Life’s function?
Gift of Life is a full service organ recovery organization that acts as the intermediary between donors, physicians and hospital staff, and provides all services necessary for organ and tissue donation and transplantation. This includes education, retrieval, preservation, and organ placement, as well as tissue typing services, and the statewide donor registry for the transplant centers within the state of Michigan.
4. How is Gift of Life funded?
Gift of Life charges a service fee to the receiving transplant center for each organ recovered. This fee is then added to the recipient patient's hospital bill. In addition, Gift of Life reports its costs of operations to the Medicare Program. Fees received from hospitals for kidneys are compared to this cost report, and an annual settlement is conducted between Gift of Life and the Medicare Program to ensure that Gift of Life is paid its full cost for recovery of kidneys, but not more than its actual cost of such recoveries.
5. How large of an organization is Gift of Life?
Presently, Gift of Life employs 167 staff members, including an Executive Director, Associate Executive Director, Tissue Recovery, Laboratory, Information Technology, Public Education, and Finance. Other staff positions include Donation Coordinators, Hospital Development Associates, Technologists and support staff.
6. Who are the people responsible for hospitals in the different
regions of the state?
Gift of Life Hospital Development Associates are available to assist hospitals throughout the state by providing education on organ and tissue donation. These individuals assist the hospitals in establishing donation procedures and internal protocol. Donation Coordinators go to the hospital when there is a potential donor to consult with the family about their donation opportunity. Following consent to donate, the on-site coordinator evaluates and maintains the donor, and generally assists in all phases of the donation procedure from identification through surgical removal of the organs. These coordinators live in the area of Michigan that they service, but all work through the central office in Ann Arbor Gift of Life Michigan is available 24-hours a day by calling 1.800.482.4881.
7. What services does Gift of Life provide?
Hospitals are mandated by Medicare to call their designated organ recovery organization with every death. Gift of Life provides 24-hour service for the screening and evaluation of donors, and the retrieval, perfusion, transportation, histocompatibility testing, and recipient allocation of organs, and the evaluation and retrieval of all tissue donors. Gift of Life and the Michigan Eye-Bank, a division of Midwest Eye-Banks, have a collaborative tissue program. Gift of Life’s histocompatibility laboratory is responsible for serology testing, tissue typing, and crossmatching of organ recipients. Gift of Life also coordinates education programs for hospital and the community at large.
8. What financial support does Gift of Life provide to the hospitals who
have a potential organ donor?
Gift of Life pays for all hospital charges associated with the organ and tissue donation recovery. This includes any donor evaluation tests that are requested in order to ensure the suitability of the donor, and the operating room costs that pertain to the organ donation. There is no cost to the donor's family or estate for organ and tissue donation.
9. The steps in the organ donation process.
a. Patient is admitted to hospital and all attempts are made to treat severe head injuries.
b. Death occurs
- Patient on a ventilator with traumatic brain injury with irreversible cessation of brain function is pronounced brain dead after evaluation, testing and documentation.
c. Referral made to the organ recovery organization to evaluate the suitability of patient for donation. The Donor Registry is accessed, to determine intentions of potential donor. The family is offered the opportunity to donate organs and tissue.
d. Written consent is obtained from the Donor Registry if documented, or from the donor’s family.
e. In some cases, the medical examiner will be notified.
f. Donor is maintained on a ventilator and stabilized with fluids and drugs. Many tests are completed to determine if each organ is healthy and suitable for transplant.
g. Recipients are identified for placement of the organs, according to the established protocol of the United Network for Organ Sharing (UNOS).
h. Surgical teams are mobilized and coordinated to arrive at the donor hospital for the organ recovery surgery.
i. Donor is brought to the operating room on the ventilator after the surgical teams have arrived at the donor.
j. The surgical organ recovery is performed. Organs are cooled and preserved with special solutions. Teams immediately return to their transplant centers, with recovered organ(s), to perform the transplant surgery.
k. Tissue donation takes place after the organ donation is complete.
l. Autopsy is performed, if requested, after the donation process is completed.
m. Donor is released to the family for funeral arrangements to proceed. Donation need not interfere with an open-casket funeral.
n. Gift of Life provides donor family with information about the recipients of their gift. Confidentiality is maintained.
10. Tissue Donation Process.
Can include corneas, bone, skin, heart valves, blood vessels, ligaments, tendons, and other soft tissue.
a. The hospital calls Gift of Life with donor information.
b. Tissue donor criteria:
- Death has occurred
- Ventilator support is not required
- Consent from donor, as recorded in the Donor Registry, or from legal
next-of-kin is obtained
c. Upon completion of the screening, the tissue recovery arrangements are made.
11. Policy Area.
a. Uniform Anatomical Gift Law:
Under this act, any individual of sound mind who is at least 18 years of age may give all or part of his/her body for education, research, therapy, transplantation, or the advancement of medical or dental science. If at the time of death, the deceased has not consented to the donation, but has not expressed a contrary intent, these persons may authorize donations in the following order of priority: spouse, adult son/daughter, either parent, adult brother/sister, guardian or person authorized or obligated to dispose of the body, assuming no member of the same or prior class opposes the gift. Consent under the uniform anatomical gift act authorizes any medical examination necessary to ensure the medical acceptability of the donation.
b. Definition of Brain Death:
The state of Michigan has brain death legislation which states that any person will be considered dead if there is irreversible cessation of spontaneous brain functions. Death is to be pronounced before artificial means of supporting respiratory and circulatory functions are terminated.
c. Advanced Directives:
Medicare regulations require hospitals to request of inpatients if they have designated a patient advocate who would become their spokesperson should they become incapacitated. In that document, a person can request that he or she wishes to become an organ and tissue donor at the time of death. A person can also state their wishes in a Durable Power of Attorney for Health Care. A Living Will is another avenue whereby a person can state their wish to be an organ and/or tissue donor. Signing the Gift of Life Donor Registry assures that your wishes will be followed if donation is a possibility at the time of death.
d. Required Request:
Current state and national legislation require that whenever death occurs in a hospital, the family of the decedent will be offered the opportunity to donate organs and tissues for transplantation.
e. Network Arrangements:
Gift of Life is a member of the United Network for Organ Sharing (UNOS) which acts as the transplant network for the entire country. UNOS has a national computer system which all recovery organizations, including Gift of Life, use for the placement of all organs, both locally and nationally throughout the United States .
f. Regulation of Private Sector Activities:
Federal and state legislation prohibit the sale of organs.
g. Quality Issue Associated With Recovery:
All donors are screened for communicable diseases, including AIDS, HIV, hepatitis, syphilis, and cytomegalovirus. In addition, screening for systemic infection is conducted.
h. Donor Anonymity:
Gift of Life protects the identity of every donor and never releases that information without expressed authorization from the donor’s family.
12. Description of current practices for maximizing the use of organs.
Other than kidneys, organs are not retrieved unless a recipient has been identified and all arrangements made for the use of the organ. This is due to the short time span from retrieval to transplant in which the recipient must be prepared and ready to receive the organ (within four hours for lungs and heart, and 8 to 12 hours for liver). Because the storage time for kidneys is longer (up to 24 hours), and the size and weight matching characteristics are not required, they can be retrieved before specific recipients are determined. If there are no compatible recipients in Michigan, organs are shared on a national basis according to UNOS regulations.
