In NSW the donation, retrieval and use of human tissues, such as solid organs (e.g. heart, liver, lungs, kidneys and pancreas) and tissue (e.g. eyes, bones, tendons and heart valves) for transplantation from both living and deceased donors is regulated by the Human Tissue Act 1983.
Increasing Organ Donation in NSW: Government Plan 2012 provides the strategic framework for donation in NSW. Implementation of the Plan is overseen by an Implementation Advisory Committee chaired by the Chief Health Officer.
The NSW Ministry of Health is responsible for ensuring that the best possible organ and tissue donation services are provided in NSW. This includes maintaining policy and legislative frameworks to ensure that human tissue is used safely, ethically, and effectively; and monitoring organ and tissue donation performance.
The NSW Organ and Tissue Donation Service (OTDS) provides clinical and operational leadership for organ and tissue donation in NSW. Detailed information on organ and tissue donation in NSW, including facts and statistics, is available from the OTDS.
Two types of donation for transplantation are carried out in NSW:
The DonateLife website has information to help you make a decision about organ and tissue donation. It also has information on talking with your family about organ and tissue donation.
You can register as an organ and tissue donor on the Australian Organ Donor Register.
You can register your objection to being an organ and tissue donor on the Australian Organ Donor Register
In Australia, families are asked to consent to organ and tissue donation, even if a person has registered their decision to be a donor. When you die your senior available next of kin may be asked if they consent to donate your organs and tissues for transplantation. S/He can decide not to donate your organs and tissues, even if you wanted to be a donor.
It is important that you discuss your decision to be an organ and tissue donor with your family. Families who know each other's donation decisions are more likely to uphold them.
No. Under the Human Tissue Act 1983 if you objected to organ and tissue donation during your lifetime and there is no evidence that you changed your mind, no one can consent to the donation of organs or tissues from your body.
It is not possible to donate organs if you die outside a hospital, however it may be possible to become a tissue donor.
The reason people cannot donate organs if they die outside hospital is because they have to be artificially ventilated in order for death to occur in a way which makes organ donation possible. This usually happens in hospital intensive care units or emergency departments.
There are two pathways to deceased donation (after death):
Brain death is when a person dies because the blood and oxygen supply to their brain stops. The brain stops working and dies with no possibility of recovery. This is usually as a result of severe injury to the brain or bleeding in the brain (i.e. a stroke).
Donation after circulatory death occurs when a person is not expected to survive a severe illness or injury. If the person is being treated in an intensive care unit or emergency department, a medical decision is made to withdraw life sustaining treatment. Organ donation can only go ahead if the person dies within 90 minutes after withdrawal of life sustaining treatment. Once the heart and circulation stop, 5 minutes must elapse to establish that the circulation has permanently stopped. Death can then be declared. Tissue donation is possible after circulation standstill.
It may be possible for you to donate kidneys, lungs, liver, pancreas, heart, intestine, eyes, bone, tendons and heart valves.
In NSW kidneys and partial livers can be donated by living donors.
It is possible for a living donor to donate an organ for transplantation into an identified recipient, usually a spouse /partner, family member, or close friend.
You must meet certain criteria to be a donor. These are outlined in PD2022_036 Living Kidney Donation and Transplantation.
NSW also participates in the Australian Paired Kidney Exchange (AKX) Programme. The AKX Programme identifies matches for patients who are eligible for a kidney transplant, and have a living donor who is willing but unable to donate because of an incompatible blood type or tissue type. This option is known as paired kidney exchange or paired kidney donation.
The AKX Programme uses a computer program to search the entire available database of registered recipient/donor pairs to look for combinations where the donor in an incompatible pair can be matched to a recipient in another pair. If the computer finds a compatible match, two or more simultaneous transplants can occur by exchanging donors.
Yes. Non-directed (altruistic) kidney donation is where a person donates a single kidney to any suitable stranger on the waiting list. You must meet certain criteria to be a non-directed kidney donor. These are outlined in PD2022_036 Living Kidney Donation and Transplantation.
You have to be willing to donate to a friend or relative, or an unrelated stranger as an altruistic act (for no personal benefit). You also have to complete a series of medical and psychological tests, and meet medical and surgical requirements to be a donor. Contact your doctor for more detailed information about the process, including the surgery to remove the organ for transplantation.
Yes. There is an Australian Government program which provides financial support for living donors. See Supporting Leave for Living Donors Scheme.
Transplant units also provide emotional and social support for living donors.
Living tissue donation for transplantation includes blood, bone marrow, cord blood and femoral heads from patients who are undergoing hip replacement. Femoral heads can be made into bone grafts. For more information on these programs visit the Australian Red Cross Blood Service, the Australian Bone Marrow Donor Registry and the Sydney Cord Blood Bank or talk to your doctor if you are having a hip replacement.
Yes, from 26 July 2024 changes to the Human Tissue Act 1983 (NSW) will allow ante-mortem interventions in NSW for potential tissue donors who lack capacity, where there is:
In both cases, there are important safeguards that must be adhered to. These are explained below.
The designated officer is a specific person within a hospital who has undergone special training on the functions of the role. In both these cases the potential tissue donor, during their lifetime, must have not expressed objections to the carrying out of ante-mortem procedures on themselves.
First person consent continues to be permitted.
All proposed interventions need to be explained to family members in advance as part of the usual organ donation consent process.
Where there is a known senior available next of kin, they can provide consent, where they are satisfied that there is no reason to believe the potential tissue donor has expressed an objection to the carrying out of ante-mortem interventions. Following the senior available next of kin’s consent, the designated officer can authorise the ante-mortem interventions.
Where there are no known senior available next of kin, the designated officer is able to authorise ante-mortem interventions provided they are satisfied that:
Prior to a designated officer authorising ante-mortem interventions on a potential tissue donor, additional safeguards must be met. These safeguards require a senior doctor (prescribed practitioner) to certify in writing that they are reasonably satisfied:
Like the designated officer, the prescribed practitioner must not be involved in the care of the patient. The prescribed practitioner must also not be involved in the care of a potential transplant recipient or transplantation generally.
It is really important that you write down and discuss your wishes about organ donation with your family, so they are very clear about your preferences.
This way, if they are asked to consent to organ donation and any ante-mortem interventions on your behalf (because you do not have capacity to make decisions yourself), they will be able to make decisions that reflect your wishes.
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No. Your existing registration on the Australian Organ Donor Register remains in place.
Anyone who wishes to become an organ donor can register on the Australian Organ Donor Register.
If a family member (next of kin) is asked to consider organ donation and ante-mortem interventions for a dying loved one who has not previously registered to be an organ donor, the family member should think about what their loved one would want, based on their knowledge of that person's wishes and values.
Hospitals have specially trained staff to answer any questions and support family members while they make their decision.