Yasna Lara has one of the most sensitive and delicate jobs at Western Health – asking the grieving families of dying or dead patients if they’re willing to donate their loved one’s organs or tissue to people needing transplants.
Ms Lara, a nurse donation specialist, is part of a small team of donor experts based at Western Hospital’s Intensive Care Unit in Footscray.
Her fellow team members – Dr Forbes McGain, a medical donations specialist and Ms Kylie Chalmers, a nurse donation specialist – navigate their way through the emotional turmoil of deeply distressed families, comforting them and helping them consider the difficult issue of organ donation.
“Organ donation isn’t for everyone and that’s fair enough,” Ms Lara said. “Our role is to support patients and their families no matter what decision they make.”
The number of families nationwide providing consent for organ and tissue donation has risen steadily since 2009 when the national Organ and Tissue Authority was established to increase public awareness about organ donation and lift the rate of families consenting to the procedure.
Ms Lara has witnessed the change in public attitudes first-hand. When she started her job more than 10 years ago, the number of donor patients at the hospital was about one per year.
In 2013 five patients at the hospital became donor patients. The number fluctuates each year, depending on whether a donor’s organs are suitable for transplant or whether a recipient patient is available and can be matched.
When a patient at the hospital is dying or has died, the treating doctor introduces the patient’s family to the donation specialist team. Ms Lara said most families are interested in the idea of organ and tissue donation.
“When we approach families to talk with them you can often see the difference between those who’ve discussed the issue of organ donation and know their loved ones wishes and those who haven’t.
“Families who’ve already discussed it feel a lot more confident about making a decision, while families who haven’t previously discussed it find it harder to make that decision.”
Ms Lara said the discussions sometimes help families in their grieving process. “For families who have talked about organ and tissue donation it can be a very positive thing to discuss – to have something good come out of something so sad. We’ve had families say that to us.
“It’s an amazing thing for people to think of other families and how they might be able to help them when they’re going through such a hard time themselves.”
Hearts, kidneys, lungs and livers are the most common organs donated for transplants. Eyes, bone and heart values are the most commonly donated tissues.
If a family consents to organ and tissue donation Ms Lara’s team then links the patient and the families to the medical staff who organise for the transplant process to occur.
The donor specialist team also provides information, case reviews and updates to all the medical staff in the hospital’s departments who may have worked with the patient. It also passes on information about the transplant results to the staff involved and to patients’ families if they wish to receive such information.
The information comes from the DonateLife Network, the national agency of hospital-based medical specialists that coordinates organ and tissue transplants. To meet privacy concerns the information does not identify the transplant recipient.
“We support the families and the staff involved in the process, from the treating teams in emergency, in intensive care and the theatre staff,” Ms Lara said. “We’re involved from the beginning to the end of the process.
“Organ donation can be a very emotional experience for everyone involved. So it’s good for people to know the end result, to know that a person’s lungs went to a young person who is now recovering well or a person’s kidneys went to a middle-aged man who is now off dialysis.”
Ms Lara says families are often surprised to learn that older patients can become donors and that people who have hip replacement operations are able to donate their old hip for reuse. Instead of being discarded, a patient’s old hipbone can be ground into powder form, sent to a tissue bank and then used in hospitals when patients need bone-grafting surgery.
The specialist team also plays a leading role in educating community groups about the importance of organ and tissue donation and how it can improve or indeed save the lives of severely ill people waiting for transplants. Ms Lara and her colleagues regularly deliver information seminars to men’s groups, young people, ethnic groups and others whom research shows are less likely than others to seek medical help.