I agree that detailed information regarding my donation, from recovery through transplantation, has been made available to me through this registration. By submitting this registration, I affirm that I am the applicant described on this application and that the information entered herein is true and correct to the best of my knowledge. This registration will serve as a registration of my document of gift as outlined in the Arizona Uniform Anatomical Gift Act. A document of gift not revoked by the donor before death is irreversible and does not require the authorization of any other person.
The following information is intended to provide you with information on the process of donation. If you have any questions or would like further explanation on this section, please call Donor Network of Arizona at 800-94-DONOR (800-943-6667). I understand and authorize the following as indicated by my signature for authorization at the end of this document:
Organs and tissues that may be donated to save and heal the lives of others include: heart, lungs, liver, kidneys, pancreas, intestine, corneas, heart valves, veins, skin, bones and other related tissues.
Donation requires both a physician’s legal declaration of death and the decision to help others. There is no cost to the family or estate for anything related to the donation. All unrelated hospital charges and funeral expenses remain the family or estate's responsibility. Donated organs and tissues are gifts; neither a donor’s estate, nor the authorizing individual will receive monetary compensation or valuable consideration in exchange for the donation.
All unrelated hospital charges and funeral expenses remain the family or estate's responsibility.
The privacy and the confidentiality of the donor and the decision for donation will be respected. Information will be shared with those individuals and organizations involved in the donation process; this will include hospital and transplantation staff, the funeral provider and the medical examiner’s office. Copies of medical records, the death certificate and the autopsy report, if there is one, will be obtained and reviewed.
Every hospital in the state of Arizona is federally required to call Donor Network of Arizona (DNA) to report an in-hospital death. When a death occurs outside of a hospital, family members can call the family support line at 602-200-7935 to notify DNA of their loved one’s passing. From there, DNA will begin the process for potential donation.
Part of the donor evaluation process requires transmissible disease testing. These tests are performed to ensure the safety of transplant recipients. Arizona law requires that positive confirmed tests be reported to the Arizona Department of Health Services. Authorization for donation includes all medical evaluations, testing, treatment and procedures needed to facilitate donation.
Recovery of the spleen and lymph nodes ensures compatibility between donor and transplant recipients. Medical blood products may be administered, and blood vessels may be recovered to facilitate safe organ transplantation. Organs may be placed on a clinical device before transplantation to improve results for transplant recipients. Local, state and federal guidelines and transplantation standards direct the allocation of organs. During the evaluation process, it may be determined that recovery and/or transplantation are not possible because of a variety of factors such as incompatibility and other medical considerations.
Through medical breakthroughs, recovered tissue can be reshaped and reformed to accommodate a variety of transplant needs. Tissue can be used for reconstructive purposes, therapeutic interventions and for corrective and cosmetic reasons. At times, tissue may be sent to help people in other countries. Also, in order to benefit the greatest number of recipients, both nonprofit and for-profit organizations may be involved in the process.
The work of recovering organs and tissues is performed with care and does not normally interfere with funeral arrangements. Donation includes the careful restoration of the donor. Bruising and swelling are rare but can occur. The donor may be transported to a donation facility for recovery procedures. The medical examiner’s office will determine if an evaluation or autopsy is necessary and if any restrictions regarding the donation process are required. Following the recovery of anatomical gifts and the medical examiner’s evaluation (if applicable), funeral plans and/or other arrangements may proceed.
A donor’s decision for donation is a document of gift as outlined in the Arizona Uniform Anatomical Gift Act. A document of gift cannot be changed by anyone other than the individual and does not require the approval of any other person. Donor Network of Arizona assures an individual that their personal and legal right to make this decision will be respected.
