Zusammenfassung
Nach dem definitiven Eintritt des Todes können bei Verstorbenen innerhalb einer postmortalen Frist von 36 h z. B. für muskuloskeletale und kardiovaskuläre Gewebe, Haut bzw. 72 h für eine Cornea Gewebe zur Transplantation entnommen werden, sofern dies in Übereinstimmung mit dem zu Lebzeiten geäußerten Willen und in Abhängigkeit von der medizinischen und sozialen Vorgeschichte geschieht. Eine Organspende kommt ausschließlich bei hirntoten Patienten mit erhaltener Herz-Kreislauf-Funktion in Betracht. Multiorganspender können – bei Vorrang der Organspende – zusätzlich Gewebe spenden. Gewebeübertragungen unterliegen im Gegensatz zur Organtransplantation keiner Kompatibiltätsanforderung, d. h., jeder Spender kann für jeden Empfänger Gewebe zur Verfügung stellen. Anders als die Organspende (Deutsche Stiftung Organtransplantation, DSO) ist die Gewebespende nicht zentral organisiert. Zwar besteht laut Transplantationsgesetz (TPG) die Verpflichtung, Spender der nächsten Gewebeeinrichtung zu melden; dies unterbleibt jedoch häufig aus Unkenntnis der Strukturen und nichterkanntem Spenderwillen. Der vorliegende Text beschreibt rechtliche, medizinische und soziale Voraussetzungen, Organisation, Ablauf und Transplantationsindikationen postmortaler Gewebespenden.
Abstract
After confirmation of death, tissues can be explanted from the deceased for transplantation purposes within a post-mortem period of 36 h (e.g. cardiovascular, musculoskeletal tissue and skin donations) or 72 h (cornea donation) in accordance with the donors’ wishes expressed while they were alive and depending on the medical and social history. In contrast, an organ donation can only be considered in cases of brain dead patients in whom the cardiovascular function is maintained. Multiple organ donors can also donate tissue although organ donation has priority. In contrast to organ transplantation, tissue transfer does not have to conform to any compatibility requirements, i.e. every donor can donate tissue for any recipient. While organ donation is organized centrally by the“Deutsche Stiftung Organtransplantation” (DSO, German Foundation for Organ Transplantation), tissue donation is not. The“Transplantationsgesetz” (TPG, German Transplantation Act) stipulates that the donor must be reported to the nearest tissue institution; however, this is often neglected due to ignorance of existing structures or not knowing the donor’s wishes. The following text describes the legal, medical and social prerequisites, the organization and process as well as transplantation indications for post-mortem tissue donation.
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Interessenkonflikt. B. Wulff, M. Graw, K. Püschel, A. Heinemann und C. Braun geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.
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Wulff, B., Graw, M., Püschel, K. et al. Postmortale Gewebespende in der Rechtsmedizin. Rechtsmedizin 24, 221–231 (2014). https://doi.org/10.1007/s00194-014-0956-3
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DOI: https://doi.org/10.1007/s00194-014-0956-3