Tissue

Being a tissue donor is one of the greatest acts of generosity a person can do after their death and a right recognized by the World Health Organization. Through donation, healthy tissues are obtained to be transplanted to people in need.

Today, there are many pathologies where the only or the best treatment solution is a tissue transplant.

Human tissues are groups of cells, organized in a structure, that have a specific function in the body. They can be classified into several categories:

1. Ocular tissues:
   - Cornea: the outer layer of the eye that helps improve vision.
   - Other ocular tissues: include parts such as the sclera, to repair the eyeball.

2. Musculoskeletal tissues:
   - Bones: provide support and structure to the body. They can be used to repair fractures or other pathologies and surgeries in other specialties that require a bone contribution, such as in traumatology, neurosurgery, or maxillofacial surgery.
   - Cartilage: specific structure of the joints that facilitates movement. It does not regenerate on its own, so it is important in injuries that require replacement.
   - Tendons: connect muscles to bones and can be used to repair ligament injuries, such as a torn knee ligament.

3. Skin: protective barrier of the body that prevents infections and dehydration. Its use is fundamental to treat large burns and prevent complications that could result in the patient's death. In the case of the dermis, it can be used to regenerate areas with significant defects; for example, for the repair of the abdominal wall, tendon injuries, or breast reconstruction after cancer.

4. Heart valves: essential for the proper functioning of the heart. In case of dysfunction, they can be replaced by a donor heart valve. In certain situations, such as in pediatric patients or women of childbearing age, it is the chosen treatment over mechanical prostheses.

5. Placenta: given its richness in factors that promote wound healing, it is used to treat a large number of pathologies, for example, in the field of ophthalmology (corneal ulcers or dry eye) or dermatology (vascular ulcers).

• In life: some donations are made during life without compromising the health of the donor. A recipient of a heart transplant can donate the heart valves of the diseased heart. A pregnant woman can donate the placenta at the time of delivery.
• After death: most donations are made after the death of the person. Always with the utmost respect for the donor, a team of healthcare professionals is responsible, on one hand, for reviewing the medical history to ensure that there is no risk of disease transmission or infections to the recipients of these tissues, and, on the other hand, for the surgical procedure to obtain these tissues.

In our country, every citizen is considered a universal organ and tissue donor, unless they explicitly express opposition during their lifetime. This includes people of all ages, as long as the necessary medical conditions for donation are met. In the case of minors or legally incapacitated persons, it is their legal representatives who must give consent for donation.

In the specific case of tissue donation, the death does not need to occur in a hospital environment.

• Consent: It is essential that the donor has clearly expressed their desire to donate tissues to their close circle. This can be done during life through legal documents such as advance directives or the donor card, which formalizes their will. The people in the donor's circle (family or friends) will always be asked if the donor had expressed their will or opposition to donation during life. Therefore, it is of vital importance to clearly communicate this will to avoid possible doubts or conflicts at the time of donation. In the event that the deceased person did not express their choice during life, it is up to their close circle to make the decision.

Donation is a process that begins with consent and evaluation of the person's medical history. The process to obtain tissues is a surgical procedure that depends on whether it is a donation during life or after death. Once the tissues are obtained, they are prepared and stored under optimal conditions at the Blood and Tissue Bank to maintain their properties until they are needed for a transplant. Tissues are stored with strict protocols to ensure their quality and safety before they are transplanted to patients in need.