Tissue-only donation
Most patients who die in the ICU, and many who die on the wards, in a hospice or in the community, can be considered for tissue donation. It is possible when organ donation does not go ahead, and it is not limited to the ICU.
It does not have to happen immediately. Tissue donation can be facilitated up to 48 hours after death.
What can be donated?
Tissue banks each have their own exclusion criteria. Many patients with a history of cancer can donate eye tissue but not cardiovascular tissue or skin. The donor coordinator, working with the tissue banks, determines what can be donated.
Who can be a tissue donor?
Eyes, from 10 to 85 years. Skin, from 10 years with no upper age limit. Heart valves, from newborns of 3.5 kg up to 70 years.
What rules a patient out?
Donation is not possible where the patient:
- died of an unknown cause
- had a significant neurological disorder — Alzheimer's disease, Parkinson's disease, Huntington's chorea, multiple sclerosis, motor neurone disease, dementia or unexplained neurological symptoms, CJD in the patient or immediate family, current or recurring Guillain-Barré syndrome, chronic idiopathic demyelinating polyneuropathy, or died with an undiagnosed neurological disease
- was positive for hepatitis B (HBsAg), hepatitis C, syphilis, or HIV
- had a haematological cancer — leukaemia, lymphoma, myeloma, myeloproliferative neoplasms, primary polycythaemia vera — or metastatic melanoma. Secondary polycythaemia is acceptable.
Donation may still be possible with any other cancer, a connective tissue or auto-immune disease — rheumatoid arthritis, polyarteritis nodosa, SLE, myasthenia gravis. Call (09) 630 0935 to discuss before offering donation to the patient or their whānau.
If you are unsure, call. A conversation settles eligibility before anything is said at the bedside.
When and how do I raise it?
Offer donation only once the patient and whānau understand and accept the prognosis. Their grief comes first. Donation is something we offer information about, never something we ask of them. Each whānau has the right to make their own decision, and no assumptions should be made about what a person's culture or faith means for that decision.
Possible phrases:
Give the whānau time to consider what you have shared. Involve cultural and spiritual support services where appropriate — Māori, Pacific or other cultural health services, or chaplaincy. Share the ODNZ tissue donation brochure if it would help. Document the conversation in the clinical notes.
The full guidance on when and how to raise donation.
Read our guidelines on the process for discussing donation with the whānau, including when to discuss donation and recommended language.
