Human tissue donation and transplantation offer patients in need a wonderful opportunity at restorative health and quality of life; that would otherwise have been impossible.
People from every walk of life depend on organ and tissue donations, regardless of race, origin, religion or language.
The need for organ and tissue transplantation is great yet impossible to overcome without people who, despite the pain and absolute finality of death, still find it within themselves to make the decision to help others in need.
Despite the fact that a person may be registered as a donor, SA law requires that the next-of-kin sign consent for the donation at the time of death. It is therefore vital that family members discuss donation well in advance to ensure that their wishes are fulfilled.
There are numerous myths surrounding the donation and retrieval process. Some people might think it is against their religion to donate, or worry that the procedure is disfiguring. Others wonder about the cost involved, or who in fact will benefit from their loved one’s donation. Even others think their loved one was too young, too old, or too sick to be a donor. The information provided on this platform is designed to address these questions.
Everyone is a potential donor, and tissue is generally retrieved from people between 15 and 80 years, but cornea and heart valves can also be retrieved from small children.
The public is encouraged to discuss their thoughts about tissue donation with members of their family. Physicians and medical caregivers are encouraged to become familiar with the various donation possibilities and to pay close attention to the wishes of the family. Although not an easy task, offering the option to donate to a bereaved family often brings comfort in a seemingly hopeless situation, through the knowledge that their loved ones live on by way of helping others. The majority of religions support donation as a final act of compassion and generosity, and a means of showing love for another individual.
Although thousands of patients receive tissue transplants annually, there is still a great deal of ignorance around the fact that donors are required, and that the selfless gift of one donor can enable doctors to treat up to 65 or more patients.
What tissue can be donated?
Eye tissue donation
Cornea and sclera (white of the eye) – donation of eye tissue facilitates corneal and sclera transplantation.
The cornea is the thin clear tissue which covers the coloured part of the eye (iris) and pupil. It allows light to pass through to the retina allowing sight. When problems develop in the cornea, people’s vision rapidly deteriorates. Disease, infection, injury and scarring can leave the cornea cloudy or distorted, causing vision loss.
Donated eye tissue can prevent blindness and can restore sight to people who are partially or completely blind due to corneal damage following a genetic condition, illness or injury.
Injuries such as injury on duty, for example chemical burns in the eye, or object injury due to a motor vehicle accident can cause severe damage to the cornea, and create a desperate need for corneal transplant.
Many South African patients urgently require corneal transplants but due to the shortage of corneal tissue only a fraction of people are privileged enough to receive the gift of sight.
Only the very top outermost layer of skin (epidermis) is carefully removed from some areas of the donor’s body, to effectively treat burn victims. Uncontrolled shack fires cause life threatening burn wounds to thousands of South Africans every year, most of whom are children. Without donor skin these people suffer agonizing injuries and often face certain death.
Skin grafting has been medically recognised as the most effective way to minimise scarring and promote healing of severe burns. Children particularly need skin grafts as a small burn or scald can cover most of their body, and these skin grafts may prove lifesaving. A burn patient suffering with severe burns may need repeated skin grafts from numerous donors until their burns heal sufficiently.
When skin is donated, only a very thin layer (similar to tissue paper) is removed and the area from which it is retrieved looks like a light graze.
Living tissue donation
Unlike most other tissues, bone tissue can also be donated by living persons – this at the time of hip replacement. The femoral head can be donated to the tissue bank who will remove all the diseased parts of the tissue and then utilise the remaining bone in certain application. This tissue is then used in some Neuro and Orthopaedic procedures to improve quality of life in recipients.
Heart tissue donation
Sometimes, even in the case where the deceased’s heart is no longer beating, the organ may be donated and the aortic and pulmonary valves transplanted to correct a heart abnormality within another patient. Heart tissue donations are often used to repair congenital defects in young children and babies and to replace diseased valves in adults. Heart tissue donation allows transplants that improve or restore the patients’ health and quality of life, and sometimes save lives.
Whilst artificial valves and even certain animal valves can also be used, human heart tissue is preferable because it is more resistant to infection, and can enable the recipient to lead a life without the need for ‘chronic’ blood thinning medication. This factor makes human heart valves safer for women of childbearing age and allows children to lead normal active lives.
Bone and tendon donation
Bone is the second most commonly used donated tissue (only blood is donated and received more regularly). Donated bone and tendons can be grafted to replace bone and ligaments that have been lost as a result of disease, tumours or injury, restoring health and in some cases independence and mobility.
Donation can enhance fracture healing, strengthen hip and knee joint replacements, replace torn ligaments or repair spinal deformities. Donation can also save a limb in a person who has developed cancer and would otherwise be facing limb amputation.
Without these essential transplants, the recipients’ opportunity to lead normal, healthy and active lives would be impossible.