Two programs two differing systems

This paper is the result of the first evaluation of the Donor Tissue Bank of Victoria's (DTBV) approaches to families to offer the option of tissue donation. The DTBV has pioneered a new and developing community health service resulting in the provision of 2,318 allografts to surgeons throughout Australia from January 1994 to December 1997. Based within the Coronial Services Centre, the DTBV experience is with families associated with reportable deaths. The location of the program within a Coronial Centre is a significant feature and leads to a range of unique practice differences compared to a hospital donation/transplantation program. However there is a paucity of literature about tissue donation from cadaveric donor apart from what is known about organ donation, with most studies treating tissue and organ donation as the same. Thus ensuring differences between tissue donation and organ donation have not been articulated and to some extent have not been realised. The DTBV is the only tissue bank in Australia, which has been set up as part of Coronial Services. The DTBV was established in 1989 to provide a central facility for the acquisition, processing, storage and distribution of tissue for transplantation. Making a donation to a tissue bank does not have the same sense of immediacy as organ donation to a recipient. Tissue donation is not necessarily life-saving, but is it always life-enhancing. Whilst there are overlaps between hospital based programs and the DTBV program, significant differences exist. In this developing and unique area of practice, the role and functions of the transplant coordinators demands skills across two differing paradigms, the physical/biological sciences and the social sciences. The demands of meeting the requirements of both paradigms as central to many of the challenges and tensions in the Transplant Coordinator's work. The primary purpose of the evaluation was to describe, analyse and theorise the practice of the transplant coordinators in relation to their approaches to potential tissue donor families. The components included the evaluation of current practice in light of current literature and recommendations for improvements to current DTBV practice. This paper will outline the service, identify and articulate the similarities and highlight the differences between the DTBV practices and those of other Transplant Coordinators in a range of settings across Australia