A person agrees with the organ donation .Before transplantation which thing should be done as priority?

NORCET 2 -2021 (Shift-2)

Medical & Surgical Nursing

Medium

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

Biochemical cross-matching is the highest priority action immediately before transplantation.
Its primary purpose is to detect pre-formed donor-specific antibodies in the recipient's serum that would cause hyperacute rejection.
Hyperacute rejection is a rapid, antibody-mediated response that leads to thrombosis and necrosis of the graft within minutes to hours.
A positive crossmatch is considered an absolute immunologic contraindication for the transplant, making this test the final and most critical safety check.

Option A: While obtaining consent is a critical ethical and legal step, if the deceased person had already provided legal consent for donation (e.g., on a driver's license or in a will), this is the primary authorization. Family consent, while sought, is not the highest medical priority immediately preceding the surgery.
Option B: ABO blood group compatibility is a fundamental and mandatory initial step in the matching process. However, it is not the final or highest priority check. A compatible blood type does not rule out the presence of other antibodies that can cause rejection.
Option D: Screening for viral markers like HIV, HBV, and HCV is crucial for the long-term health of the recipient and to prevent disease transmission. However, it does not address the immediate, catastrophic risk of hyperacute rejection, which would destroy the organ long before any viral illness could manifest.

Visual 1: Flowchart: Pre-Transplantation Workflow. A diagram showing the sequence of events: 1. Donor Identification & Consent -> 2. ABO Blood Typing -> 3. HLA Tissue Typing -> 4. Viral & Infectious Disease Screening -> 5. Final Crossmatch -> 6. Organ Transplant Surgery. This visual clarifies that crossmatching is the final critical step.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Pre-transplantation assessment priorities in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A nurse's role in the transplant process includes meticulously verifying that all pre-operative checks, including the final crossmatch results, are completed and documented in the patient's chart before the patient goes to the operating room. This is a critical patient safety checkpoint.
Failure to confirm a negative crossmatch can lead to a futile surgery, loss of a precious organ, and severe, life-threatening complications for the recipient.
What if? If the final crossmatch comes back positive for a planned living donor transplant, the procedure is immediately cancelled or postponed. For a deceased donor, the organ is then offered to the next suitable, crossmatch-negative recipient on the waitlist.

How to Approach the Question

First, identify the key term in the question: 'priority'. This indicates you must rank the importance of the given actions.
The context is 'before transplantation', implying the final steps before surgery.
Consider the most immediate and life-threatening complication that can occur during transplantation. This is hyperacute rejection, which destroys the organ within minutes.
Evaluate each option to see which one directly prevents this immediate, catastrophic event.
Consent is a legal/ethical step. Blood typing is an early screen. Viral markers prevent long-term infection. Only biochemical cross-matching specifically detects the pre-formed antibodies that cause hyperacute rejection, making it the highest priority.

Concept Tested & Keywords

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