כל אחד מאתנו יכול לתת חיים!
 

Q & A

What is a donor card and why is it called "Adi"?

The Adi card is called after Ehud Ben Dror, who died while waiting for a kidney donation. Signature of an Adi donor card testifies to the willingness of the holder to donate his/her organs after death, for saving the lives of patients waiting for transplant. The bank of the Adi donor cards signatories is computerized and it is managed by the National Transplant Center, affiliated to the Ministry of Health. The database of Adi is confidential. 

Who can sign a donor card?

Anyone who is an Israeli citizen, from age 17 to age 120, can sign a donor card, regardless of his or her health state. In any case, the organs shall be examined in real time so as to ensure that they are healthy and fully functional. 

Can a donor card be cancelled?

Yes! It is possible to reconsider and to cancel adherence at any moment. All that has to be done is to notify the National Transplant Center by means of fax or e-mail. 

Is it necessary to renew the donor card periodically?

No! This is not necessary. Only citizens who have adhered to Adi prior to 1989 have to renew their cards. 

What happens if I am willing to donate my organs, but my family refuses?

The signature of the donor card testifies to the will of the holder, but the family is always consulted. Therefore the family is also entitled to refuse.  According to our experience, fulfilling the will of their loved one is a thing of outmost importance for the families, and, for this reason, they endeavor to comply with his or her wish, even if they are against it – and they donate his or her organs. 

If the signature of the donor card does not ensure the possibility of automatic harvesting of the organs of the holder, why is it important to sign?

For a number of reasons. The signature represents a statement of general acknowledgement of the importance of organ donation and of human approach. It is also a statement of intention of the donor, which helps the family in making a decision as to donating his or her organs. Moreover, the signature of the donor card grants transplant priority, in case of need. 

Has a donor card holder priority when waiting for a transplant?

The Organ Transplant Law, 2008, includes an article – the first and the only one of its kind in the world – that grants priority on the transplant waiting list to the signatories of the donor card and to their close relatives, should they, by misfortune, need a transplant in the future. 

I am afraid of the evil eye. Is the signature of the card not a reason for worry?

Everybody is entitled to his or her own system of beliefs and opinions. However, any insurance (accidents, diseases) should be regarded in the same manner – and yet we all take insurance policies and are aware of their importance.  Instead of developing irrational fears, the signature of the card should be considered as a human act, which, if anything, shall protect the signatory. 

Who is responsible for the entire donation and transplant system in Israel?

The matter of transplants in Israel is regulated and managed by the Ministry of Health, by means of the National Transplant Center. One of the functions of the Center consists in centralizing the waiting list and ensuring organ allocation based on meticulous medical criteria including: medical compatibility, waiting period and urgency of the transplant. 

What is an organ transplant and why is it needed?

Modern medicine succeeded in eradicating many diseases; however, numerous systems in the body are affected by genetic and by acquired diseases that cause the organ to fail. By means of the transplant procedure, the dysfunctional or totally non-functional organ is replaced by a functional organ. 

How are patients selected for transplant?

The allocation (distribution) of the organs to the patients on the waiting list is done by computer, according to criteria such as blood type, height and weight, medical emergency, age, waiting period, tissue match between the donor and the patient, as well as other medical criteria. 

What are the success rates of transplant surgeries?

The medical field is making enormous progress. In the course of the years, medicine keeps acquiring new modalities that ensure full and effective acceptance of the transplanted organ. Nowadays, the transplant procedures carried out in Israel have very high success rates, and the rate of surviving patients a year after the transplant is over 90 %, similar to that of other western countries. There are people living in Israel nowadays who have undergone transplants 15 and 20 years ago. 

Can people who have undergone transplants lead a normal life?

People who have undergone organ or tissue transplants can lead a full and normal life. They can go back to work, engage in sports, travel, bring children to the world and lead a normal life. The transplant of a human organ is the best possible alternative to the failing organ. However, it should be remembered that transplant is a treatment, rather than a cure for the disease. Therefore, the transplant patients have to take anti-rejection medication on a daily basis and to undergo regular medical tests.

Can the family of the donor know the identity of the recipients? Can the recipient know the identity of the donor?

It depends upon the wish of the family of the donor and on that of the recipients. Many families of donors have formed a special relation with the recipients. Some of them say that a part of their loved one goes on living. 

How many people in Israel were saved by organ transplant or organ donation?

In an average year, about 250 transplants are carried out in Israel on adults and on children, who receive a new life. Every year, about 300 new patients, both adults and children, join the waiting list. 

How many people are waiting for a transplant in Israel?

There are over 1000 children and adults in Israel waiting for a transplant. About 700 are waiting for a kidney transplant, about 150 for a liver transplant, about 70 for a lung transplant and about 120 for a heart transplant. Only 250 people on the waiting list will have the chance of a transplant in the course of the next year and about 100 will die waiting. And each year, hundreds of new patients join the waiting list. The number of the waiting patients is dynamic and is updated at the beginning of each year. 

What organs and tissues can be donated?

Organs: heart, lung, liver, pancreas, and kidney. Tissues: corneas, skin, bones, and valves. One donor can save seven persons. 

When can organs be donated? What is the difference between brain-respiratory death and cardiac death?

 1.A. Cardiac death – cessation of the respiratory and heart activity. In this state, only tissues, rather than organs, can be harvested.

2. B. Brain-respiratory death – total and irreversible cessation of the activity of the brain stem, which is responsible for all the vital systems, including consciousness, respiration capacity, blood pressure and pulse. In spite of the medical care, brain stem death will always lead to system collapse and to cardiac arrest within a relatively short period of time. No one has ever regained consciousness after brain stem death. Organ donation is possible only after pronouncement of brain-respiratory death

Why is organ donation possible only after brain-respiratory death?

Because in a state of brain-respiratory death it is possible, for a limited period of time, to preserve artificially the function of the organs. This is the time for organ harvesting. Afterwards, the organs will stop functioning and the body systems will collapse, in spite of medical care. 

Have there been cases in which brain-respiratory death was established, and the patient regained conscience later?

The answer is no. No one has ever regained consciousness after brain stem death. Sometimes the term "brain death" is used incorrectly to describe a vegetative or comatose state. The people who have "woken up" had been in a deep comatose state, in which the brain stem went on functioning and there had been a cessation of blood supply to the brain. They had not been in a state of brain-respiratory death. 

What about people in a comatose state?

Coma is a different medical state and it has no relevance whatsoever for organ donation. The brain stem of a person in a comatose state functions, and he or she is capable of breathing autonomously. Coming out of a coma is possible. 

Is there any suspicion that the doctors will hurry pronouncing brain-respiratory death in order to receive organ donations?

Doctors are trained to save human life. This is against reason that they should want to speed up the death of one human being in order to save another. In any case, the establishment of brain-respiratory death is based on scrupulous medical-clinical diagnosis and machine test and is carried out by two specialist physicians who have received designated training to this effect. This is in accordance with a strict procedure of the Ministry of Health, governed by the Law of Brain-Respiratory Death, 2008. There have never been found any irregularities in the pronouncements of the physicians. 

What happens after brain-respiratory death is pronounced?

The members of the medical team will approach the family of the deceased and advise them to donate his or her organs, thus making possible for the lives of patients waiting for transplants to be saved. The transplant coordinator provides guidance to the families during the entire process. 

Is there any age or health state limitation for organ donors?

In case of certain organs, such as the heart, a young donor, under the age of 55, is preferable; however, nowadays, thanks to medical progress, it is possible to receive organs from donors of any age, up to 75-80 years old.
For each donor, a health state assessment is done, based on which his or her donation capacity is established. Nowadays, even organs of patients suffering from grave diseases are taken. The decision is always made by physicians, based on the full picture of all the factors. 

Is it possible to have a transplant without being placed on the waiting list?

There is no possibility whatsoever. The issue of transplant In Israel is regulated and managed by the Ministry of Health, by means of the National Transplant Center. This is the sole organism in Israel dealing with this matter. Any transplant candidate is registered in the database of the Center, as is any organ for transplant. The organ allocation policy is egalitarian, computerized and transparent and is based solely on medical and relevant considerations.

How is harvesting surgery carried out?

Organ donation is done in a sterile operating room, like any regular surgical procedure. 

Is there any postponement of burial?

Organ donation does not postpone the time of burial. The burial arrangements are the usual ones; the time of burial set by the family is always taken into consideration. 

What does Halacha say in this matter?

According to the majority of the rabbis, organ donation, when carried out in accordance with halachic law, credits the deceased donor and his/her family with the highest virtue both in the Upper Worlds and in this world.
Organ donation joins together the highest commandment of life saving and bestowing kindness. All religions are in favor of organ donation for life saving.
All rabbinic rulings that authorize organ donation (and even regard it as a commandment) set one single restriction: donation is permissible only if carried out in accordance with halachic laws. At the heart of the halachic problem lies the establishing of the death of a person – which has to be done according to halachic laws.
In September 2009, the Chief Rabbinate, led by the Rishon LeZion, Rabbi Shlomo Amar, and by the Chief Rabbi of Israel, Rabbi Yona Metzger, confirmed the fact that the Brain-Respiratory Death Law is in accordance with Halacha; and consequently, that it was unreservedly possible to implement the 1986 ruling of the Rabbinate, which permitted organ donation on condition that death was established according to Halacha.
The halachic circles that equate the moment of halachic death with the stopping of the heart activity cannot be part of organ donation, as organ removal prior to the arrest of the heart activity would mean, in fact, taking life.
In order to remove any doubt as to organ donation from the point of view of Halacha, it is possible to stipulate that the donation be conditional upon the authorization of a clergyman chosen by the family.

What does the Israeli legislation say?

  • The Knesset passed the Organ Transplant Law in 5768-2008. The law prohibits for the first time organ traffic and brokerage, and thus the State of Israel joins a long list of countries engaged in fighting organ traffic, such as the USA, Canada, Belgium, Spain, England, and others. Beyond this express prohibition, it was ruled that infringement of this disposition represents a criminal offense subject to criminal sanction.
  • The law grants "insurance" by means of credit points (score increase) on the waiting list to the holders of an Adi card, as well as to the families that have donated the organs of their loved ones, in the unfortunate situation that they or their first-degree relatives should need a transplant.
    Under the new law, holders of an Adi donor card ensure priority for themselves and for their close relatives on the waiting list for an organ donation, should they need a transplant in the future.

Is it possible to donate the body to science and also to sign the donor card?

Yes! It is possible to register for both aims in parallel. 

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