Understanding Donations
Brain Death vs. Cardiac Death
Q. What does brain death mean?
A. Brain death means there is no blood flow or oxygen to the brain, therefore the brain cannot function in any capacity and never will again. It does not mean that the other organs, such as the heart, lungs, kidneys, pancreas and liver are dead, although they may only function for a few days. Unless damaged by disease or injury, these organs may be used by another individual in need of an organ transplant.
Q. How is brain death determined?
A. A physician performs a series of tests to determine whether or not brain death has occurred. Death is indicated if the patient:
- cannot breath without assistance
- has no pupil response to light
- has no response to pain
Q. Why does the heart continue to beat?
A. The heart has its own pacemaker, independent of the brain. With oxygen, the heart will continue to beat.
Q. Would removing the respiratory support from a patient be the same as not giving him or her all possible chances for survival?
A. Once the patient is brain dead, he or she is dead because the brain will not recover. Respiratory support equipment only keeps the heart beating, supplying the vital organs with oxygen.
Q. Does the body of a brain dead patient sometimes begin to deteriorate even if the patient is on life support?
A. The failure of many organs begins soon after brain death.
Q. Does the patient feel any pain during donation?
A. No, the person is dead and no longer feels pain.
The recorded time of death is when the patient is declared dead, not when the heart actually stops beating. There are no clinically documented cases where a patient was declared brain dead and later restored to a normal life. Federal regulations mandate that all families of brain dead patients be offered the option of organ and tissue donation.
Cardiac Death
Cardiac death means the patient is without oxygen. His or her heart has stopped beating. Tissue and eye donation are options after cardiac death has occurred. Some of these tissues include bone, heart valves, veins, skin and soft connective tissues, such as tendons.
Non-Heartbeating Organ Donation
In some instances, a person may donate organs after cardiac death has occurred. For non-heartbeating organ donation to occur the following circumstances must exist:
- A patient has suffered devastating and unrecoverable brain damage resulting in ventilator dependency;
- The family has decided to withdraw mechanical ventilation;
- Death from cardiac and respiratory arrest will occur within one hour following withdrawal of mechanical support.
- In this situation, organ recovery would occur only after support is withdrawn and after cardiac death is pronounced.