Death before Organ Donation

Understanding Death before Organ Donation

There are two legal definitions of death, cardiopulmonary death and brain death. Cardiopulmonary death is when the function to the heart and lungs has been lost and is not reversible. Brain death is when blood to the brain has stopped and brain function has permanently ceased.

Organ Donation after Brain Death

When a patient has a brain injury that is not survivable, a physician performs a series of tests to determine if brain death has occurred. When brain death occurs there is a loss of life-sustaining reflexes such as the ability to breath, gag, or respond to pain. Brain death can be confusing for families who are confronted with the sudden death a loved one. A brain dead person on a ventilator can feel warm to the touch and can look "alive". The heart is still beating and the ventilator is pushing oxygen and air into the lungs making the person’s chest rise and fall. Patients who are brain dead can be maintained on ventilator support for a short period of time. Regardless of ventilator support, organ failure will occur. This is why time is critical in the donation process.

This image of the brain shows blood flow inside the brain. The animation shows a "simulation" of how blood flow to the brain ends or is shut off as the brain swells in a brain injured patient. The absence of blood flow will lead to brain death, a legal and medical determination of death.

Source: www.organtransplants.org Used with permission.

Organ Donation after Cardiac Death

Some people with non-survivable injuries to the brain never become brain dead because they retain some minor brain stem function. In these circumstances donation after cardiac death might be an option. The option of donating organs after cardiac death may be presented to these families after it is clear that their loved one cannot survive. Donation in such cases entails taking the patient off the ventilator. Once the patient's heart stops beating, the physician declares the patient dead and organs can be removed for transplant.