In addition to organs such as heart, lung, liver, kidney and pancreas, there are numerous tissues that can also be transplanted. Tissue transplants can be both life saving and life enhancing. Skin grafts for burn victims and heart-valve replacements are examples of life-saving transplants. Transplants, which improve quality of life, are corneal transplants for visual impairment and bone transplants for limb reconstruction.

What kinds of tissue can be donated?
Corneas, skin, bone, cardiovascular tissue (heart valves and veins), the pancreas for islet cells and connective tissue are the most common tissues transplanted. One donor can provide tissue for many recipients undergoing various procedures reconstructive orthopaedic surgery, eye surgery, burns and plastic reconstructive surgery, cardiac surgery, neurosurgery, ear nose and throat surgery, and dental surgery. Bone marrow can also be donated but only by living donors, such as a relative or another person with matching tissue.

Cornea
The cornea is the clear tissue at the front of your eye. This tissue can become damaged as a result of disease, trauma, or infection. Corneal transplants can help restore vision in those with damaged or diseased corneas. Scleral transplants (using the white portion of the eye) are used for reconstructive eye surgery and glaucoma procedures.

Skin
Split-thickness skin grafts are used primarily as a biological dressing for patients with large burns. Only a very thin layer of skin (less than 15/1000 of an inch, which is similar to a skin abrasion) is removed from the donor. These grafts are necessary to prevent fluid loss, protect the patient from bacterial infection, and decrease pain.

Bone
Bone can be transplanted as an entire portion or it can be processed into different forms, such as powder, chips, struts or dowels depending on the type of surgery it is required for. Bone can be used for
• reconstructing hip and knee joints due to arthritis or bone disease
• fusing the spine
• preventing limb amputation following tumour removal
• replacing or repairing bone lost or damaged as a result of trauma or cancer
• reconstructing mandibular defects in dental surgery
• reconstructing developmental bone defects in children

Cardiovascular tissue
Heart valves are used to replace diseased or damaged valves in adults or to replace valves in children born with valve defects. Saphenous veins can be used for cardiac bypass operations and for replacing damaged or diseased vessels with decreased blood flow.

Pancreas (islet cells)
Islet cells are retrieved from donor pancreata and transplanted into people suffering from Type I diabetes. Islet cells are transplanted directly following isolation and purification, without prior storage. In a person with type 1 diabetes, the insulin producing cells are attacked by the immune system and are destroyed, leading to a deficiency of insulin and high blood sugar. For the person with diabetes to survive, insulin has to either be provided by injections or the islet cells can be transplanted to provide insulin.

Connective tissue
Several connective tissues can be transplanted. Pericardium is used to repair damaged ear drums (tympanic membrane) in ear surgery. Dura, the membrane covering brain and spinal cord, is used in neurosurgery to repair dural defects. Fascia lata (a covering of your muscles) can be used to replace damaged tendons or as a patch graft similar to pericardium. Ligaments and tendons can be used to repair joint tissue damaged from trauma or disease.

Bone marrow
Bone marrow is a spongy tissue found in the breast bone, ribs, hip bones, skull, and spine. Bone marrow transplantation is used to treat several diseases of the immune and blood systems, including aplastic anemia, severe combined immune deficiency, some pediatric genetic disorders, and some cancers.

Who can donate?
Almost anyone of any age can be a tissue donor. Tissue quality and suitability are assessed on an individual basis once a potential donor is identified.

How is tissue obtained?
Tissue is usually obtained and processed in a sterile environment. All tissue is carefully removed by trained surgical teams. Tissue that is removed is replaced with surgical substitutes and all incisions are surgically closed. After the procedure, there is no indication that tissue or organ procurement has taken place so tissue and organ donors can have an open-casket funeral. Bone tissue can also be donated by living patients undergoing joint replacement therapy in which a portion of their bone is removed and replaced with a prosthesis. With bone marrow donation, bone marrow is removed from the living donor's pelvic bones. The procedure, performed under general anesthesia in an operating room, takes 15-45 minutes.

Why donate tissue?
As with organs, the demand for transplantable tissue far outweighs the supply. Each year, only a small portion of tissue that could be used for transplant is obtained. The waiting list for corneal transplants alone is astounding. Having skin available for a traumatic burn can be critical to patient survival. Your decision to become an organ and tissue donor can help save or drastically improve the lives of up to 100 people.

How do I become a tissue donor?
Provinces allow you to express your wishes to become a donor in a number of ways: signing a donor card, indicating your request on your driver's license or health card, or signing a donor registration form. Probably the most effective way, however, is to inform your family and loved ones of your wishes to donate your organs and tissues. If you want to be registered as a potential bone marrow donor, you can contact the Canadian Blood Services click here.

As only 35% of patients have a compatible donor in their family, the Unrelated Bone Marrow Registry provides possible donors for patients who do not have a relative with matching tissue.