Between the thread on donating one’s organs and a Scrubs I saw last night, I was wondering - how much testing do they have time to do on organs? I know it varies by organ on how much time they have before they need to stick it in somebody or lose it - how many tests can they run? Say you come in with the classic motorcycle accident and they know nothing about you, but your family consents and they’ve got all these young, healthy organs that other people desperately need. In the Scrubs episode the autopsy came back the next day:
They thought she had died of a cocaine overdose, but it turned out to be, for no good reason, rabies. All of the recipients died.
Is that sort of thing possible? If so, how common is it?
The testing is done on the donor before life support is withdrawn. There’s usually several hours between the person being pronounced brain-dead and the actual harvest.
Scrubs is a TV show. The medical information is, for the most part, made up. It doesn’t mimic reality in any way…
So if somebody dies in the ambulance ride or whatever, it’s possible to hook them to the pumps and stuff and keep their organs alive long enough to do the testing you need to do?
What about diseases that don’t reliably show up on tests when they’re recently infected? Is it just not a common problem?
I strongly suspect that organs would not be harvested from someone who died of a cocaine overdose. That has to be a TV inaccuracy. The question is, why didn’t they know what the donor in the true story died of? From the linked article, it looks like they didn’t suspect the actual cause of death until the donees developed symptoms.
I don’t know if rabies can cause a brain hemorrhage, but if you see a brain hemorrhaged, odds are you’re going to suspect that as the cause of death. And it’s very plausible(and indeed, is done in practice) to harvest organs from those dying of an overdose. It’s possible to “flush” out the drugs from the organs.
Is that true? I thought about that when I watched the show. If you’re that in need of an organ, it seems plausible. The cocaine would flush out of your body with in a matter of two days or so.
I wondered about this, being as how Hema-Quebec believes that my blood is instantly deadly due to a terminal case of teh ghey, and yet the government foolishly permits me to donate my organs. Could they really test better for disease in a time-critical situation involving major organs than in a less time-critical situation involving donated blood?
The difference is likely due to difference in value of the respective body parts. Organs are in very high demand, and there is a short supply of them. Blood, on the other hand, is generally plentiful. It’s not necessary to take blood from high-risk donors.
If I recall the real-life story the Scrubs episode was based on, the donor died of a brain hemorrhage post-accident (motorcylce oops?). He was not showing any symptoms whatsoever of rabies and subsequent investigation that he was still in the asymptomatic period and had no way of knowing he had rabies. They weren’t even sure exactly how he had been infected.
Rabies is very rare in the US, and there isn’t a really quick test for it - it’s not, at present, practical to test donors for it.
Or days. When my mother died and we gave permission to harvest we asked that they leave her on life support so that her family could fly in. They did most, if not all, of their testing before they took her off life support. I know they already had at least a couple of people lined up so they must have matched her organs a day or so before. I remember they told us which organs could be used whole, the lungs, liver and kidneys, and which ones couldn’t be used, her heart. I’m guessing they did a good number of tests as she was on life support for three or so days.
But nobody’s still said what happens when you die in the ambulance of your massive organ-harvest-friendly head wound from your motorcycle accident. Can they keep you technically “running” long enough to do tests? If not, are they going to give that guy who needs a heart TODAY the heart and cross their fingers? I know it’s a little extreme to expect them to test for rabies, but is there a super-fast HIV test? Hepatitis? Do they warn the recipient and give them the option - wait for organs we know more about or take these now? I know there are a lot of things you can’t donate blood for that they wouldn’t even know in the case of some accident victims - travel to certain countries, prison, teh ghey, etc.
Also, isn’t blood combined into products that may have many donors’ blood included? One donor could infect a batch, which could be given to many people, so the risk is higher. Someone who donates organs is at most endangering a single person per organ.
I don’t think that’s the case. They combine small samples of blood to do batch testing, to save time and money, but AFAIK individual units of blood are just that, individual. That little bag you fill up is the same bag they attach to someone else.
And back in the day they did combine blood, I’m thinking of a show on military medicine I saw on WWII, I think. I seem to remember it being dehydrated, at any rate, and that people got diseases from it because they didn’t know any better.
Wait, so you have to be on life support before you die to have eligible organs? I had no idea.
Sorry, I’ve been away from the board for a few days.
Zsofia, Hirundo82 is correct. If someone dies in the ambulance, they continue CPR until they reach the ER. Once there, they have more resources to restart the heart. If they can’t, then harvesting can’t be done. Even though the person may have a donor’s card, it still requires a next of kin to ok donation.
The reason a cocaine OD would not usually be a candidate for donation is because it would be considered a risky lifestyle. Their chances of having underlying disease is high. HIV and the hepatitis alphabet take a bit too long to test for thouroughly.
Nunavut Boy, you’re almost correct. Pooled platelets are not plasma, they’re platelets.
Pooled platelets are still used but, the use of single donor platelets is becoming much more common. Single donor platelets are more effective than pooled donors. The chances of an adverse reaction is lower with single donor too.
Pooled platelets are indeed platelets from several donors, but the platelets are suspended in the plasma from each donor. Most of the volume of the unit is from the plasma from each donor. The plasma fraction is also where you’d find any viruses.
As you say, single donor (or apheresis) platelets are becoming more common but at least in Canada, the majority of platelets transfused are still pooled platelets. We try to save our apheresis platelets for the patients who have been multiply transfused or have developed anti platelet antibodies.
This isn’t exactly true either. The little bag you fill up is ‘Whole Blood’ which is very rarely transfused intact. Most of the time it’s separated into components; packed Red Blood Cells (pRBC), platelets, Fresh Frozen Plasma (FFP), and cryoprecipitate and each can be transfused separately. Hence the ‘one donation can save 6 lives’ or whatever they tell you at the Red Cross.