Eligible Organ Donor for solid organ donation (Kidneys, liver, heart, pancreas):

Inclusion Criteria:

1. Age � Up to 70 years old or younger (No age limit for eye and tissue donation)
2. Brain death declaration by Govt. authorized neuro-clinicians. 

Note: Two sets of brain death certification at 6 hours apart.Second set time considered the actual timing of declared death

Exclusion Criteria for Organ Donation:

Active infections (specific diagnoses)

I. Bacterial infection

1. Tuberculosis
2. Gangrenous bowel or perforated bowel and/or intra-abdominal sepsis

II Viral infections

� HIV infection by serologic or molecular detection

� Rabies

� Reactive Hepatitis B Surface Antigen

� Retroviral infections including HTLV I/II

� Viral Encephalitis or Meningitis

� Active Herpes simplex, varicella zoster, or cytomegalovirus viremia or pneumonia

� Acute Epstein Barr Virus (mononucleosis)

� West Nile Virus infection

� SARS

III Fungal infections:

� Active infection with Cryptococcus, Aspergillus, Histoplasma, Coccidioides Active candidemia or invasive yeast infection

IV Parasites:

� Active infection with Trypanosoma cruzi (Chagas')

� Leishmania, Strongyloides, or Malaria (Plasmodium sp.)

V Prion:

� Creutzfeldt-Jacob Disease

VI Other Exclusions

� Aplastic Anemia

� Aplastic Anemia

� Agranulocytosis

� Extreme Immaturity (<500 grams or gestational age of <32 weeks)

� Current malignant neoplasms except :

� non-melanoma skin cancers such as basal cell and squamous cell cancer Primary CNS tumors without evident metastatic disease

� Previous malignant neoplasms with current evident metastatic disease

� A history of melanoma

� Hematologic malignancies: Leukemia, Hodgkin's Disease, Lymphoma, Multiple Myeloma

� Multi-system organ failure (MSOF) due to overwhelming sepsis or MSOF without sepsis defined as 3 or more systems in simultaneous failure for a period of 24 hours or more without response to treatment or resuscitation

� Active Fungal, Parasitic, viral, or Bacterial Meningitis or encephalitis

VII The following reversible causes of coma should have been excluded when declaring brain death:

� Intoxication (Alcohol)

� Depressant Drugs

� Relaxants (Neuromuscular blocking agents)

� Primary hypothermia

� Hypovolaemic shock

� Metabolic or endocrine disorders

� Previous malignant neoplasms with current evident metastatic disease

References

Fischer, S. A., Graham, M. B., Kuehnert, M. J., Kotton, C. N., Srinivasan, A., Marty, F. M., Comer, J. A., Guarner, J., Paddock, C. D., DeMeo, D. L., Shieh, W.-J., Erickson, B. R., Bandy, U., DeMaria, A. Jr., Davis, J. P., Delmonico, F. L., Pavlin, B., Likos, A., Vincent, M. J., Sealy, T. K., Goldsmith, C. S., Jernigan, D. B., Rollin, P. E., Packard, M. M., Patel, M., Rowland, C., Helfand, R. F., Nichol, S. T., Fishman, J. A., Ksiazek, T., Zaki, S. R., the LCMV in Transplant Recipients Investigation Te, (2006). Transmission of lymphocytic choriomeningitis virus by organ transplantation.. NEJM 354: 2235-2249 [Abstract] [Full Text]

Cozzi, E., Bosio, E., Seveso, M., Vadori, M., Ancona, E. (2006). Xenotransplantation--current status and future perspectives.. Br Med Bull 75-76: 99-114 [Abstract] [Full Text]

Solomon, T., Marston, D., Mallewa, M., Felton, T., Shaw, S., McElhinney, L. M, Das, K., Mansfield, K., Wainwright, J., Kwong, G. N. M., Fooks, A. R (2005). Paralytic rabies after a two week holiday in India. BMJ 331: 501-503 [Full Text]

Roos, K. L. (2005). Viral Encephalitis Transmitted From Donor to Organ Recipients. JAMA 294: 488-489 [Full Text]

Jenwitheesuk, E., Jackson, A. C., Lapierre, V., Tiberghien, P., Srinivasan, A., Kuehnert, M., Rupprecht, C. (2005). Transmission of Rabies from an Organ Donor. NEJM 352: 2551-2552 [Full Text]

Burton, E. C., Burns, D. K., Opatowsky, M. J., El-Feky, W. H., Fischbach, B., Melton, L., Sanchez, E., Randall, H., Watkins, D. L., Chang, J., Klintmalm, G. (2005). Rabies Encephalomyelitis: Clinical, Neuroradiological, and Pathological Findings in 4 Transplant Recipients. Arch Neurol 62: 873-882 [Abstract] [Full Text]

(2005). Rabies in Four Organ Transplant Recipients. JWatch Neurology 2005: 7-7 [Full Text]

(2005). Rabies Transmission via Organ Transplantation. JWatch Infect. Diseases 2005: 3-3 [Full Text]

http://www.medindia.net/tho/thoform61.asp

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