12. Who can't donate? Why can't some organs be used?

At the time of death, the organ procurement organization serving the hospital will review medical and social histories to determine donor suitability on a case-by-case basis. There are a few diseases and conditions that rule out donation. If you are HIV positive, you will not be able to donate organs. If you have active cancer in a particular organ, you cannot donate that organ. If cancer has spread through the body, you will not be able to donate any organs. A history of certain kinds of cancer, particularly brain tumors, may allow for organ donation depending on the particular circumstances and how likely it is that a particular recipient may die if the organ is not used. A history of cancer in the distant past that is likely to be cured may not rule out organ donation.

In the case of death by injury, sometimes the organs are too damaged by either the original injury, or by the problems caused by the injury, for them to be used in other people. The medical examiner has the legal right not to allow organ donation if they feel that the deceased person may have died in such a way that there will later be a legal inquiry, such as a murder. However, this happens very uncommonly because the removal of healthy organs from a deceased person virtually never affects the legal case.

Sometimes the donor's condition changes suddenly, such as might happen if the donor's blood pressure unexpectedly plummets, and the donation cannot occur quickly enough for the organs to remain viable. Also, there are occasional situations where the donated organs are thought to be viable, but once they are visualized in the operating room, they are found to be damaged or otherwise unsuitable for transplantation due to unsuspected disease. This news can be very disappointing for the donor's family, and for the waiting recipients, too.

All donors are tested for a wide range of diseases and conditions before the donation takes place. Blood tests and other examinations are done to test the function of specific organs, and all donors are tested for HIV, hepatitis, and other viruses that might be dangerous to transplant into a recipient.

Lastly, the donor's family is interviewed carefully in order to obtain the potential donor's medical history. Certain behaviors prior to death can increase the chances that a donor may have (unsuspected) HIV disease. The Centers for Disease Control in Atlanta, Georgia has put together a publication that includes a set of questions that are asked of all donors. A positive response to one or more of these questions doesn't necessarily rule out donation, but it may alert the donation team to potential problems.

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