Thank you
for your support of organ and tissue donation.
First Responder Donor Referral
RESOURCE GUIDE Your courage helps to save lives.
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Shante´ Wells, Director of Donation Systems Your unselfish gestures of compassion during each and every work day is heroic. And while we often grieve for the individuals whose lives we cannot save, we can take comfort knowing they with your help - can benefit others through donation. This booklet is designed to guide you through the donation process. LifeGift is proud to partner with you, and your agency, to save lives through organ and tissue donation.
About LIFEGIFT
We Offer Hope It’s the commitment to those waiting for lifesaving and life-enhancing organ and tissue transplants that drives LifeGift to innovate – to save the lives of men, women and children. Established in 1987, LifeGift is a not-for-profit organ procurement organization (OPO) dedicated to recovering organs and tissue for individuals needing transplants in 109 Texas counties and more than 240 hospitals in Southeast, North and West Texas. Organs and tissue are a precious community resource. LifeGift is an integral part of the healthcare community helping to manage this critical resource. Thousands of residents in the areas we serve, and beyond, have had their life restored by receiving organ and tissue transplants provided through our unique partnerships.
In the world of transplantation, recovered organs and tissue means more lives saved This laser focus on recovering organs and tissue is why LifeGift is one of the nation’s largest organ recovery agencies and is consistently ranked as one of the most innovative and effective Organ Procurement Organizations (OPOs). LifeGift staff members help train emergency medical services (EMS) personnel, fire & rescue, law enforcement and hospital staff members on 1
all aspects of donation, from the appropriate identification and timing for referrals of potential donors to the medical maintenance of the donor and the recovery operation. We ensure that organ and tissue donation is conducted in a fully coordinated, professional and respectful manner by expert donation specialists. For the families of donors, we provide information on the donation process, the placement of organs and tissue, the progress of recipients, as well as the bereavement process. 
Our organization blends the talents and dedication of many Physicians, hospital administrators, community members, donor families, organ and tissue recipients, EMS personnel, fire & rescue, law enforcement and LifeGift staff members are all vital to the success of organ and tissue donation. LifeGift, its partner hospitals, EMS, fire & rescue and law enforcement, seamlessly collaborate to ensure that family members who desire to donate their loved one’s organs and tissue have the opportunity to do so. Together, we continually seek to develop effective, government-regulated donation systems. In this way, we can ensure that patients desperately waiting for transplants will have access to the precious and critically short supply of these organs and tissue.
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Donating ORGANS & TISSUE Once the donation process has begun, it is not unusual for families to have additional questions. LifeGift is committed to maintaining transparency and open communication throughout the donation and beyond. We appreciate your collaboration and hope the following information helps you understand the significant need as well as the organ and tissue donation process.
Consenting to Donation Every donation begins with a selfless decision to help others. LifeGift works with each family to ensure that the opportunity for donation is offered to anyone eligible. The legal next of kin will be approached with the option of donation. The goal of the conversation is to help determine what the deceased would have wanted. When the decision is made to donate tissue, consent is obtained on a recorded phone line. The decedent’s identity will remain confidential and within the federal Health Insurance Portability and Accountability Act (HIPAA) regulations.
A Declaration of Death is Made and Consent is Obtained Organs If brain death has been declared, tests will be completed to identify the medical suitability of organs to determine if the individual can be a donor. If so, the patient will remain on the ventilator, and will be supported with fluids and medications to keep oxygen and blood flowing to the organs. 3
Tissue If cardiac death has been declared, tests will be completed to identify medical suitability of tissue. A single tissue donor can touch the lives of up to 80 people through the donation of corneas, bone, skin, veins, tendons, ligaments and heart valves. The process can occur up to 24 hours after death.
FUNCTIONS AND APPLICATIONS
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Gifts of Donation: Organs and Tissue 1. EYES/CORNEAS
7. VEINS
Application: restores vision to the blind
Application: restores blood flow to ischemic areas of the heart; restores blood flow for limb salvage, dialysis access
Function: allows light to enter the eye to provide sight
2. LUNGS
Function: provides oxygen to the blood Application: replacement for patients with cystic fibrosis, emphysema or other endstage lung disease
3. HEART/HEART VALVES
Function: pumps blood to the body Application: organ and aortic pulmonary and mitral valves can be transplanted to correct defects
Function: returns deoxygenated blood to the heart
8. KIDNEYS
Function: extracts wastes and excess water from the blood; produces hormones that help regulate blood pressure Application: replacement for patients with renal failure, removing them from dialysis
9. SMALL INTESTINE
Function: aids in digestion and the absorption of nutrients into the body
4. LIVER
Application: restores the absorption of Function: regulates energy, breaks down nutrients and other dietary needs proteins, and removes wastes from the blood Application: replacement for patients with end-stage liver disease, hepatitis or cirrhosis
5. PANCREAS
Function: secretes enzymes necessary for digestion, secretes insulin that regulates blood sugar Application: replacement of diseased pancreas in the diabetic; eliminates need for insulin injections
6. BONE
Function: structural support of the body, protects vital organs Application: facial reconstruction, limb salvage, correction of birth defects, cancer treatments, spinal and oral surgery
10. FASCIA
Function: fibrous membrane that covers, supports and separates the muscles Application: restores support, limb and soft tissue repair, reconstructive and facial repair
11. SKIN
Function: provides the body with protection from infection and necessary temperature control Application: restores the protective barrier to the body, protects against infection
12. CARTILAGE
Function: connective tissue that serves as structural support in some areas (e.g., nose and outer ear) Application: reconstructive surgery
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Testing Tests are completed to determine whether the tissue and/or organs can be donated. The United Network for Organ Sharing (UNOS) is contacted to match the organs to the most appropriate recipients through a national placement database. Tests to identify communicable diseases (e.g. syphilis, HIV, hepatitis) are performed. Recovered tissue is sent to companies which process it and return the transplantable tissue to centers in the community.
How long does the process take? The entire donation process can take up to 24-72 hours depending on the type of donation. Lifegift staff members remain on-site throughout the recovery. Every effort is made to expedite the process according to the timeline.
Recovery Tissue and/or organs are removed surgically in an operating room. The process involves an incision, which is closed and stitched at the completion of the recovery. Prosthetics and other materials are used to reconstruct the body after tissue recovery. The body is treated with the respect and dignity that would be given to any patient undergoing an operation. The ventilator is disconnected, following organ recovery.
Release of the body The body may be released to the medical examiner (ME) or to a funeral home. The ME’s office is usually located in a facility separate from the hospital. The ME determines whether an autopsy will be required, as well as the length of time a body remains at the office. For example, if the deceased dies during the weekend, the ME may not release the body to the funeral home until Tuesday. The donation process does not affect this time duration. Once the ME has completed his or her review, the body is released to the funeral home. 6
 
Donor family services Several weeks following the donation, the family will receive a letter from LifeGift. This letter will confirm the tissue and/or organs that were recovered, as well as general information on each recipient of vital organs (kidneys, liver, pancreas, intestine, heart and lungs). Names and locations of recipients are kept confidential. One tissue donor can provide tissue to benefit up to 80 people over months or even years. Exact information on tissue recipients often is unavailable. LifeGift is committed to providing families with support services by honoring the memory of their loved one and recognizing his/her gift of life. Our staff is available to answer any questions. 7
First Responder DONOR REFERRAL PROGRAM In an effort to increase donations of tissue, LifeGift created the first responder donor referral program, becoming one of the country’s few programs of its kind and the first in Texas. The Montgomery County EMS Services became the first partnering agency, providing additional opportunities for individuals to donate. Previously, the majority of tissue donations have come from people whose deaths occurred in hospitals. This program helps provide a donation opportunity to many individuals whose lives ended outside a hospital through referrals from the field. Since 2001, EMS agencies, fire & rescue and law enforcement have joined the lifesaving effort, creating a voluntary routine referral protocol, utilizing LifeGift’s 24/7, in-house communications center. And while the donation opportunity means someone has died, first responders can help in restoring or enhancing life for someone awaiting a tissue transplant.
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Why does LifeGift want to work with EMS agencies, fire & rescue and law enforcement? LifeGift believes that working with EMS, fire & rescue and law enforcement is effective in obtaining referrals of deaths outside of a hospital, often due to varying factors involving a medical examiner (ME) or justice of the peace (JP). In most of the counties served by LifeGift, a JP is involved in decedent care at the scene. The JP will decide whether the decedent will undergo an autopsy. If the autopsy is ordered, the decedent will go to an ME, which can cause delays and additional missed opportunities. For LifeGift, maintaining a working relationship with EMS agencies, fire & rescue and law enforcement is ideal because of the immediate clinical information and time saved by obtaining a referral directly from the scene.
First responder donor referral protocol This protocol is designed as a phone referral system between the LifeGift and EMS agencies, fire & rescue and law enforcement for potential tissue donations from decedents who die outside of a hospital. A death on scene is identified. 1. Obvious trauma incompatible with life 2. Extended downtime with evidence of rigor mortis or dependent lividity 3. Field termination protocol implemented The family is advised of the death or termination of effort, if applicable. Vital information is obtained from the scene by a paramedic. 1. Location of deceased 2. Next of kin or contact person’s name 3. Next of kin or contact person’s phone number 4. Name, age, sex and race of deceased 5. Mechanism of injury 6. Brief medical history, if available 7. Justice of the peace, if applicable 8. Law enforcement contact, if applicable 9. Funeral home of choice, if applicable
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A call is initiated from the scene by a paramedic to LifeGift at 800.633.6562, reporting the following: 1. Name of referring EMS, fire & rescue or law enforcement employee 2. Agency name and unit/Medic number 3. Station or Communications Center phone number 4. All vital information requested above LifeGift will provide follow-up information directly to the referring crew on the outcome. 1. By phone within 24 hours, if applicable 2. Referring individual will receive a confirmation letter within one month
24/7 Communications Center Every few minutes, 24 hours a day, 365 days a year, the phone rings at the LifeGift Communications Center in Houston. It’s immediately answered by a team of more than 20 dedicated employees who understand that each call can potentially save or enhance the lives of up to 80 individuals. The state-of-the-art Communications Center receives and coordinates tissue and organ referrals in LifeGift’s service area, which covers more than 240 hospitals. Because it is required by law for each hospital to report every death to LifeGift - more than 30,000 each year - the “Comm Center” maintains a fastpaced, yet focused environment.
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Communications Center specialists assess each referral for donation suitability, based on such criteria as age, cause of death and medical history. When a potential donor is identified, the specialist will notify fellow LifeGift staff members to report to the hospital and begin the donation process. For potential tissue-only donors, Communication Center specialists must secure consent from the families through a phone call. It’s during these times, the specialists’ gift for communication truly shines. Using calm, reassuring voices, the specialists provide comfort to the families while explaining the great need for tissue donation. They discuss which tissue can be donated, how they could be used and answer any questions. Once the families understand all options, the specialists ask for consent to donate their loved ones’ tissue. This innovative approach used by the Communications Center has been a model for numerous tissue and organ recovery agencies nationwide. And thanks in part to the skill of the Center’s staff, LifeGift Tissue Recovery Services recovers close to 1,500 donations of bone, skin, heart valves, saphenous veins and femoral veins each year - improving the lives of potentially thousands of cancer patients, burn victims, children born with congenital defects and others.
OUR LIFESAVING Result RESULTS Our Lifesaving
as of Dec. 2018
Organ Donors
as of Dec 2018
391 100
200
300
400
500
1200
1500
1,078
Tissue Donors 300
600
900
Organs & Tissue Transplanted
1,223 300
600
900
1200
1500
Source of data: Donate Life Texas
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Regulatory ISSUES
How does HIPAA affect the first responder donor referral program? Federal privacy regulations on patient records and information as a result of the Health Insurance Portability and Accountability Act (HIPAA) do not affect the patient information that hospitals and healthcare facilities release to LifeGift. As an organ procurement organization (OPO) and healthcare partner with hospitals, EMS agencies, fire & rescue, law enforcement, funeral homes and medical examiners, LifeGift is specifically exempt from HIPAA regulations restricting release of a patient’s medical records and health information and is not considered a business associate subject to business associate contacts. The privacy rule specifically designates that OPOs are permitted to use and disclose protected health information without the patient’s authorization for the purpose of public interest and benefit activities. Under HIPAA’s 45 CFR 164.512 (2) (h), “Uses and Disclosures for Cadaveric Donation of Organs, Eyes or Tissue, a covered entity may use or disclose protected health information to organ procurement organizations and other entities engaged in the procurement, banking or transplantation of cadaveric organs, eyes or tissue for purpose of facilitating organ, eye or tissue donation and transplantation.” The regulations also state that OPOs are exempt “because persons who make such donations are not seeking health care themselves but are seeking to contribute to the health care of others.”
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The Texas Anatomical Gift Act and organ and tissue donation A person who acts in good faith in accordance with Sections 692.013 and 692.014 is not liable as a result of the action except in the case of the person’s own negligence. For purposes of this subsection, “good faith” in determining the appropriate person authorized to donate under Section 692.004 means making a reasonable effort to locate the member or members of the highest priority class who are available at or near the time of death. If the decedent is a donor 18 years of age of older, the decedent’s anatomical gift made under Section 692.003, including a gift made under Section 11B, Chapter 173, Acts of the 47th Legislature, Regular Session, 1941 (Article 6687b, Vernon’s Texas Civil Statutes), shall be honored without obtaining the approval or consent of any other person.
Live Life. Give Life. Be a Hero.
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Facts About DONATION Myths and misconceptions The need is great for organs and tissue in the United States. Despite continuing efforts at public education, myths about donation persist. The following are facts about donation.
MYTH: I don’t need to tell my family that I want to be an organ and tissue donor because I have it written in my will.
MYTH: If I am in an accident and the hospital knows that I want to be an organ and tissue donor, the doctors will not try to save my life. FACT: Organ and tissue recovery takes place only after all efforts to save your life have been exhausted and death has been legally declared. The medical team treating you is completely separate from the transplant team. The organ procurement organization (OPO) notifies the transplant team following consent to donation. MYTH: Donation will mutilate my body. FACT: Donated organs and tissue are removed surgically, in a routine operation similar to open-heart surgery. Donation doesn’t prevent an open-casket funeral or viewing. 14
FACT: By the time your will is read, it will be too late to recover your organs and tissue. Telling your family now that you wish to be a donor is the best way to ensure that your wishes are carried out. MYTH: I am not the right age for organ or tissue donation. FACT: Organs may be donated from newborns to about age 75. There is no age limit for tissue donation. At the time of your death, the appropriate medical professionals will determine whether your organs are usable. MYTH: Only the heart, liver and kidneys can be transplanted. FACT: Needed organs include the heart, kidneys, pancreas, lungs, liver and intestines. Tissue that can be donated include the eyes, skin, bone, heart valves and tendons.
Highlights The Need There are more than 112,000 individuals waiting for transplants in the U.S. Nearly one million tissue grafts are implanted in the U.S. annually. There are approximately 25,000 organ transplants performed every year in the U.S. A transplant candidate is added to the waiting list every 10 minutes. About 7,000 patients will die every year, an average of 20 per day.
Transplantation All efforts are made to ensure the use of donated organs and tissue for people on the waiting lists. Organs are offered to people on the waiting list based solely on medical and waiting time factors regardless of their financial or social standing. All recovered tissue are initially offered to the community where the donation occurred.
Religious Views All major religions practiced in the U.S. either advocate for donation or leave the decision to the individual.
Authorization First Person Authorization – Authorization by the donor himself or herself which proclaims an individual’s desire to make the anatomical gift and requires no further authorization from next-of-kin. Next-of-kin Authorization is only considered if the potential donor is medically suitable to donate and there is no evidence of first-person authorization.
Care of the Patient Before Donation Every effort to save an individual’s life is made before a patient is considered a potential donor. Organ and tissue recovery is performed as a routine surgical procedure.
Cost No costs related to organ or tissue donation are passed on to the donor’s family. LifeGift and other organ procurement organizations are not-for-profit. The buying and selling of human organs is illegal. 15
Partnering with LIFEGIFT Partner with us LifeGift invites you and your EMS, fire & rescue or law enforcement agency to help carry the message of donation into the community. In addition to being first responders and saving lives, you now have an additional opportunity to save and enhance the lives of many people waiting for transplantable tissue.
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If you’re interested in partnering with LifeGift, please contact:
Southeast Texas Office 2510 Westridge Street Houston, TX 77054 713.523.4438 Fax 713.737.8100
North Texas Office 1000 12th Avenue Fort Worth, TX 76104 817.870.0060 Fax 817.870.2073
West Texas Office 5812 64th Street Lubbock, TX 79424 806.798.5568 Fax 806.798.5572
For more information about LifeGift or organ and tissue donation, please call 800.633.6562 or visit www.lifegift.org.
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Live Life. Give Life. Be a Hero.
800.633.6562 www.lifegift.org
©LifeGift 2020