Introduction When hospice patients asked about organ and tissue donation we had little to offer them, as patients with malignancy are normally limited to donating corneas. This paper describes a project enabling patients to donate tissue for research purposes.
The project We worked in partnership with our local bone and tissue bank, who have experience in using tissue from both live and deceased donors (eg, bone from patients who have a hip replacement). Our local NHS Research Ethics Committee agreed a proposal to enable patients to donate tissue after their death. Small samples are taken from up to 35 different tissues/organs and these can be used by pharmaceutical companies or research groups, with ethical approval. The project was approved by the Hospice Board of Trustees.
The consent process During end of life discussions consultants will raise the issue if appropriate. If patients wish to know more, they are given information leaflets describing various donation options, including corneal donation. Consent is taken by a consultant and a senior member of the bone bank. Patients specify which tissues/organs they are happy to have samples taken from. Unlike organ donation, relatives cannot consent on a patient's behalf after death. If the relative withdraws consent after death, then we do not proceed.
Tissue retrieval After death, the bone bank is informed and makes the arrangements. The body is moved to our hospital mortuary and samples are taken. The body is then restored in appearance and taken to an undertaker of the family's choice within 14 h.
Problems – or lack of them Patients and their families have been very supportive of the project. One challenge is that the body cannot be moved, nor retrieval take place, until a death certificate has been issued. This potentially limits the project for patients who die at home.
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