Every day in the United States, thousands of lives are saved or transformed through the miracle of tissue donation. Advances in medical science have allowed for tissue "grafts" to be created using the tissues of generous individuals who have decided to become organ, eye and tissue donors. Burn victims' lives are saved thanks to skin grafts from deceased donors. Athletes are given full mobility after receiving donor grafts to repair a torn ACL. Sight is restored to the blind through cornea donation. Infants' lives are saved through the transplantation of heart valves from deceased patients.
While many people understand that organ donation (the donation of heart, lungs, liver, pancreas, kidneys and small intestine) saves lives, what is not as well known is how tissue donation and transplantation saves and enhances the lives of hundreds of thousands of individuals.
What is tissue donation?
Tissue donation is the process through which a deceased individual donates parts of his/her body for use in transplants into living individuals to repair a defect or injury, to restore mobility, to restore sight, or to save a life. Tissue donation can occur after someone has designated themselves as an organ, eye and tissue donor (either when they receive or renew a driver's license, or online through a registry such as www.beadonor.org/register). If an individual has not designated themselves as an organ, eye and tissue donor at the DMV or MVA, the family member of the deceased patient may wish to make that decision for them.
What types of tissues are recovered?
- Bone is recovered and used for facial reconstruction, limb salvage, birth defect correction, cancer treatment, spinal and oral surgery. Bone is also used to replace bone which has been destroyed by infection, tumors or trauma.
- Cartilage is used for facial and other post-traumatic injury reconstruction.
- Corneas are used to restore sight in more than 45,000 transplant procedures annually.
- Fascia (the fibrous tissue that covers muscles and tendons) are used in surgical repairs for sports injuries, craniotomy, ligament repairs, maxillofacial and other surgeries.
- Heart valves are used to repair congenital cardiac defects in infants or replace cardiac valve where animal or artificial valves may not be indicated.
- Pericardium (the membrane sac surrounding the heart) is used in neurosurgery, brain operations, ophthalmic (eyelid) repairs.
- Skin is used to reduce pain, scarring, fluid loss, infection in burn patients. Full thickness skin is used in reconstruction procedures (e.g., post-mastectomy).
- Tendons and ligaments are used to rebuild damaged joints due to disease and trauma.
- Veins are used to re-establish blood circulation and to prevent loss of limbs and leg amputation. Donated veins are also used in heart bypass surgeries.
I'm an organ donor on my driver's license. Does that make me a tissue donor as well?
The laws in every state define the word "organ" as including organs, eyes and tissues. If you have registered as a donor on your driver's license, that means you are consenting to donate whatever organs, eyes or tissues are healthy enough to be donated at the time of your death. In many states (including Maryland, Virginia and the District of Columbia), you may select exactly which organs or tissues may be used for transplantation, research, education or therapy. The place to do that is on the online donor registry (you can access your state's here: www.beadonor.org/register). Thus, if you wish to restrict your gift visit your state's donor registry, sign in and follow the process.
Does having the heart on my license also mean that my organs, eyes and tissues can be used for research?
Yes. In D.C., Virginia and Maryland, registering as an organ, eye and tissue donor means that WRTC may provide organs or tissues to one of our various research partners in the event those organs or tissues are not be viable for transplant. Click here to view and read about our many tissue and research partners and protocols.
Once the tissue is recovered, where does it go?
Tissue, once it has been recovered, is sent to a tissue bank. The tissue banks then process (remove genetic material), store (tissues can last from a few weeks to several months once processed) and distribute these gifts to hospitals and doctors who request them for the medical needs of their patients.
Are tissue banks for-profit or not-for-profit entities?
In the United States, tissue banks may be for-profit or not-for-profit entities. However, all tissue banks must meet the same regulatory requirements to ensure safety and efficiency. The National Organ Transplant Act (NOTA), the federal law that legalizes all donation, does state, however, that the costs involved in recovering, processing and storing of tissue may be reimbursed. The costs that can be reimbursed also include the research and development of new technologies and medical therapies, and much more. Tissues are precious gifts, and as such have no value. However, the costs to recover, process and store may be reimbursed. The tissue profession also depends on financing of research and development to improve organ, eye and tissue transplantation outcomes for patients.
Who regulates tissue donation?
Tissue donation is covered under both federal and state law. It is regulated by the Food and Drug Administration (the FDA) as well as the American Association of Tissue Banks (AATB).
What happens to patients after a recovery takes place?
Organ donation occurs in the operating room of a hospital, just like any other surgery. Tissue donation may take place in different venues, but most often occurs in a hospital operating room as well. Once organs, eyes or tissue are recovered from a deceased donor, the body is sutured back up and prepared for transport to a funeral home. If a family has authorized the donation of bones, then those bones are replaced with a synthetic material that will provide stability in the event a family wishes to have an open-casket funeral. The recovery process is a very respectful process, and WRTC is committed to handling these patients and their gifts with care.
In the Washington, D.C., area, the families of deceased individuals are enrolled in our aftercare program. The program, called our Donor Family Advocacy Program, is managed by two full-time professionals with a combined 30+ years in the bereavement field, who are dedicated to serving all of our donor families with the utmost compassion. This program, which follows families for up to two years after the donation, consists of bereavement groups, grief resources, the opportunity to participate in our Donor Family Remembrance Quilt project, and an annual Donor Family Gathering.
Becky Hart (above) is a navy wife and mother to two teenage girls from Ashburn, VA. On May 28, 2011, Becky's life changed forever. It was Memorial Day weekend – Becky and her family were visiting with friends at a barbecue in Maryland. Her friend had recently purchased a lovely glass container that held a metal bowl inside that contained a wickless pourable gel fuel with citronella. It was beautiful. When the gel ran out and she and her friend thought the flame had been extinguished, she poured more gel fuel into the metal canister and immediately a ball of fire spewed toward Becky. At first, Becky thought it was a flare-up — similar to that of a burst of heat when you light a gas grill for the first time. But when Becky heard her friends yelling and screaming her name, she knew something was wrong. She immediately began to feel pain and knew she was on fire. Despite doing what she had been told all her life ("stop, drop and roll!") the fire could not be put out. Her friends tackled her, doing everything they could to extinguish the flames. The invisible gel clung to her skin and continued to burn. When the ambulance arrived, it was determined that she had burns over 60% to 75% of her body. She realized the severity of the burns when a young Maryland State Trooper told her that he had to cut off her wedding band to attend to her wounds. A helicopter took her to Washington Hospital Center's burn unit, where she stayed for three months.
After a few days at the hospital, she was taken into surgery where she received her first life-saving cover of skin from a deceased donor. The donor tissue is used to keep a patient alive (preventing fluid loss and infection and preventing pain) until the individual can grow their own skin.
She has since recovered fully, after three months in the hospital, numerous surgeries and after receiving several deceased donor skin grafts. Becky is now back to being a mom and a wife. She remains eternally grateful for the deceased donors and their famlies – without that skin, she would likely not be smiling today.
Terry Murray (above) is an active mom and grandmother from Silver Spring, MD, who has learned the value of tissue donation in quite a different way. She was a teacher at Springbrook High School back in 1999 when her husband Alan discovered a leak in the roof of their home. Alan decided to climb the roof to assess the damage with their son. Terry, inside the house, heard her son scream. She grabbed the phone, ran outside and found Alan unconscious on the deck – he had fallen two stories from the roof. She immediately dialed 9-1-1.
When the EMS arrived at the scene, she remembers them tearing off her husband's shirt and using defibrillator paddles to rescusitate him. They transported Alan to Holy Cross Hospital, where he was pronounced dead. The doctors explained that they did all they could, but that there was no bringing him back. That's when employees of the Washington Regional Transplant Community (WRTC) came in to speak with Terry and her family. WRTC asked Terry if her husband would want to be a donor. According to Terry, she and her children didn't need to think very long – Alan was an extremely giving individual. They knew he would want to help people in any way he could, so she said yes. Alan was able to donate his bone, skin, connective tissue and his corneas.
About a month after he passed away, Terry received a letter from an eye bank explaining that the sight of two people had been restored because of Alan's donation. And for that little piece of hope during such a tragedy, she is grateful.
To view the stories of those whose lives have been affected by tissue donation, click below.
Kat – Kat's daughter Kylie died of SIDS when she was an infant. Kat decides how she and her husband made the decision to donate Kylie's organs and tissues to research.
Chris – Chris leads a very active life. As a musical artist and minister, being able to see is a necessity for him. So when his doctor told him he needed a cornea transplant, it was a shock. But thanks to the generosity of a tissue donor, Chris was able to receive the cornea transplant that helped him get back in the game.
Rachael – Rachael lost her dad doing what he loved: biking. Rachael talks about losing her dad, what his being an organ and tissue donor meant to the family, and what they're doing now to commemorate him.
Glen – Glen always thought of herself as a "lightweight." She didn't receive a heart or a liver, just a ligament that helped her get back in the game as a mother to three boys.
Sharon – Sharon's 42-year-old daughter died of ovarian cancer. Rhonda was able to donate her corneas, and, as a result, two people benefited from her donation.
Maria and Marianne – Maria's husband (and Marianne's father), died suddenly and was able to donate tissue for use in transplant surgeries. It's something that his family is proud of. Maria and Marianne discuss their participation in the Donor Family Remembrance Quilt project through WRTC.
Ellen – Ellen's husband Neil died unexpectedly after a minor surgery. Despite this loss, Ellen's decision to allow her husband's tissues to be donated has helped so many – including her.