Running head: ORGAN DONATION

Nurses Role in Organ Donation

Melissa Winn

Colonel Rodney Sanders

Brigham Young University-Idaho

Nursing 422

November 5, 2018

Nurses Role in Organ Donation

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The process of organ donation is a very serious and thorough process. Organs are not

simply just donated and given to any patient that is in need. Rather, extensive testing and

matches are done in order to find the recipient the best possible match. This course of action is

not something that can be done by just one doctor. Instead, a team of skilled healthcare

professionals work together to match the donated organ with the right patient. Nurses are

involved in this process every step of the way and play a crucial role in the complex and detailed

work of organ donation.

The incidence of organ donation has greatly increased over the years, especially as a

better understanding of the procedures are being discovered and higher success rates are

occurring. Some of the most common transplants include organs and tissues such as heart, lung,

liver, kidney, cornea, bone marrow, and skin. The process of organ donation is something that is

very selective and not something that everyone is eligible to do. However, organ donation is

very beneficial, since many individuals would die without the donation of these vital organs.

Through the process of organ donation, whether the organ comes from a live donor or a deceased

donor, many more individuals are now able to live longer and healthier lives. One of the biggest

indicators of how successful the transplant will be is based on how closely the recipient was

matched to the donor.

An extensive amount of testing is done on the recipient, as well as on the donor before

any transplant ever occurs. Testing is done in order to match the recipient with the best possible

donor, as well as to know if the recipient and potential donor are eligible candidates for

transplantation. Patients that are obese and are smokers may not be eligible candidates for

donation. Chronic infection and untreated heart disease also restrict individuals from organ

transplant. Additionally, people with current psychosocial issues, such as alcoholism and drug
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addiction are also ineligible for transplantation. However, individuals with HIV and hepatitis B

or C are able to be transplant candidates (Lewis, Bucher, Heitkemper & Harding, 2017). All of

these tests and restrictions are put in place to ensure the greatest chance of the organ transplant

being a success. There are many individuals that are in need of a transplant, so screening is

required to ensure that the organ will go to the right candidate.

The best possible match is found in order to decrease the possibility of the organ being

rejected. These tests include blood type, HLA typing, a panel of reactive antibodies, as well as a

crossmatch. These tests are preformed on not only the donor, but also the recipient (Lewis,

2017). Although the nurse will not actually preform these tests, the nurse plays a role in this

process. Since many different tests and procedures will occur throughout this donation, the nurse

must be able to explain to the patients and their families the tests that are being completed and

the reasoning for each test. Along with the many tests that are obtained in order to find the best

match, there are also additional tests which are used to determine the health of the recipient as

well as the donor. These tests include an ECG, a chest x-ray, and additional laboratory tests.

The nurse helps by not only explaining the purpose of each test to the patient, but also in making

sure the test is completed after the doctor has placed the order.

Throughout the entire donation experience, the nurse has the role of teaching everyone

involved. The process of donating an organ, as well as receiving a new organ can be very

overwhelming. This may be a new experience for all of the involved participants. Often times

the recipient as well as the donor do not know what to fully expect, and because of this, they will

likely have a great deal of questions and concerns. This process is more than just having a

surgery to remove an organ and a surgery to put the new organ in place. It is crucial for the

nurse to explain the steps involved in organ donation to the patient and explain what they should
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expect, such as symptoms of infection, as well as signs of rejection that should be reported. The

nurse must teach the donor and the recipient about the surgical procedure itself and what exactly

will happen during the surgery, as well as what they can expect during the postoperative period.

For example, a patient that has received a kidney transplant will spend between 12 and 24 hours

in the intensive care unit (ICU) due to the close level of monitoring that is required to ensure

proper health and organ function (Lewis et al., 2017). As the nurse appropriately teaches and

informs not only the recipient and the donor, but also the family of these individuals, the nurse

will be able to help ease the nerves and anxiety of these participants.

Many of these participants have spent a number of years on the transplant waiting list,

just hoping to receive the vital organ that they need. The journey that these patients face in order

to receive a new organ is one that is both emotionally and physically exhausting. Not only is the

road leading up to receiving the organ difficult, but now that these individuals have been

matched with a donor, they have a whole new list of fears and worries. Many recipients stress

over the surgical procedure, as well as wondering if the surgery will be a success. Organ

rejection and failure is a common fear amongst organ recipients. They have waited a very long

time, and the last thing that they want is for this surgery to be unsuccessful. Nurses need to care

for the patient, as well as the family in a calm and reassuring manner (Cebeci, Sucu &

Karazeybek, 2011). This could potentially be a very tense and emotional experience for the

patient as well as their family. As the nurse works with the patient, it is their duty to provide the

best possible care, and by doing so, help to ease the stress and worries of the patient and their

family members.

Throughout the entire process of organ donation, the nurse also has the crucial role of

caring for the patient physically. Before the transplant occurs, the transplant recipient needs to
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be monitored and assessed to ensure that they are eligible to receive this transplant and that their

body will accept this new organ. After the surgical procedure the patient needs to be closely

monitored and will likely spend time in the ICU for close observation. This new organ is foreign

to the recipient. Their body may want to reject this organ, as a way of trying to protect the body.

In order to decrease the likelihood of organ rejection, when a patient receives an organ

transplant, they are placed on immunosuppressive therapy. This therapy works to decrease the

response of the immune system (Lewis et al., 2017). However, because the immune system of

the patient is decreased, these individuals are at a greater risk for infection. As the nurse

monitors and cares for the patient, it is crucial that the nurse observes for signs of infection, such

as an elevated temperature. Laboratory values must also be monitored, as tests such as white

blood cell count (WBC) will also help to indicate an infection. If the nurse observes signs of

infection or organ rejection while monitoring the patient, the early detection can greatly impact

the treatment of the patient and the success of the transplant.

Through the use of organ donation, lives are able to be greatly changed. In September of

2014 the United Network of Organ Sharing (UNOS) reported that over 123,000 people in the

United States alone were waiting for the transplant of an organ (Yoost & Crawford, 2016). This

is an astronomical number, that only continues to grow each year. There are more people that

are in need of organs than there are people able to give organs. Each day people die, because

they were unable to receive the organ that they needed in order to save their life. Organ donation

is such a powerful thing and can impact the lives of so many people. On average, one organ

donor can help save up to eight people, and many more through the use of tissue donation

(Donate Life, 2018). Personally, I believe that everyone should be an organ donor. After we die

we have absolutely no use for our organs. In my opinion, it is a waste for a healthy individual to
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be buried with their organs, when they could just as easily go to a handful of individuals that are

desperately in need. There is so much good that can come from organ donation and so many

lives can be changed for the best.

Nurses play a critical role in the process of organ donation. The nurses have many

different responsibilities when it comes to the process of donation, whether they are working to

teach the patient and ease their fears, or help physically care for the patient before or after

surgery. Organ donation is a very difficult and thorough process. A successful organ donation is

done with the help of a skilled medical team. Nurses are an important asset to this team and help

with the donation, every step of the way.

References
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Cebeci, F., Sucu, G., Karazeybek, E. (2011). The roles of nurses to augment organ donation and

transplantation: A survey of nursing students. Transplantation Proceedings, 43(2), 412-

414.

Donate Life (2018). Organ, Eye, and Tissue Donation Registration. Retrieved from

https://donatelife.net/

Lewis, S. L., Bucher, L., Heitkemper, M. M. & Harding, M. M. (2017). Medical-surgical

nursing: Assessment and management of clinical problems (10th ed.). St. Louis, MO:

Elsevier.

Yoost, B. L., & Crawford, L. R. (2016). Fundamentals of nursing: Active learning for

collaborative practice. St. Louis, MO: Elsevier.