Procedure for requesting hands, facial tissue, limbs and other vascularized composite allografts

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The following applies to organ procurement organizations, health care professionals, donees under section 8662 (relating to donees and vascularized composite allografts) and other persons who request a gift of hands, facial tissue, limbs and other vascularized composite allografts from a surrogate decision maker:

(1) The request for a donation must be made separately from a request for donation under Subchapter B (relating to express anatomical gifts). The request must explicitly and specifically identify donations of hands, facial tissue, limbs and other vascularized composite allografts as distinct from traditional organs such as heart, liver, or lung or tissues under Subchapter B. The discussion must educate the surrogate decision maker about the process of recovery of vascularized composite allografts and must clearly define and explain all of the following:

(i) What a vascularized composite allograft is, the benefit to the recipient and precisely what will be recovered.

(ii) That any prior generalized authorization for an anatomical gift under Subchapter B does not include a gift of a hand, facial tissue, limb or other vascularized composite allograft.

(iii) That permission for a gift of a hand, facial tissue, limb or other vascularized composite allograft must be given separately from the permission for a gift under Subchapter B.

(iv) That the appearance of the individual whose death is imminent or who has died in a hospital will be significantly altered after the recovery of the gift and that upon request the recovery team will perform reconstructive surgery on the individual at no cost to the individual, the individual's family or surrogate decision maker. In addition, the discussion must explain that the recovery of vascularized composite allografts may impact burial arrangements and that an open casket may not be possible.

(v) That the identity of the individual whose death is imminent or who has died in a hospital may not be able to be protected due to fingerprints or birthmarks.

(2) A deceased donor authorization form shall be used which specifically identifies the option of authorizing a gift of hands, facial tissue, limbs and other vascularized composite allografts. The form must include a provision which states that the surrogate decision maker and family of the individual whose death is imminent or who has died in a hospital understands the relevant anatomical details of the donation, the alteration of the appearance of the individual, including the impact of the recovery of vascularized composite allografts upon funeral arrangements, and that, despite the best efforts of the organ procurement organization, the anonymity of the individual may not be protected. Further, the form must provide information about the nature of the discussion required under paragraph (1), including:

(i) the date and time of the discussion;

(ii) for individuals who hold a professional or occupational license, the names, addresses, telephone numbers and professional or occupational license numbers of the individuals who made the request for the donation and provided the information under paragraph (1); and

(iii) a summary of the topics discussed and which surrogate decision maker authorized the gift of a vascularized composite allograft.

Cross References. Section 8656 is referred to in section 8658 of this title.


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