A Gift For Life Book

Questions About Organ And Tissue Donation

Perhaps the hardest thing for many families to understand is the concept of brain death. The doctors have said that your loved one is medically and legally dead. The only thing that is keeping them functioning is the machine (ventilator) that breathes for them. And yet, as you stand watching them and touch their warm skin, they merely look asleep. You almost expect that at any minute they'll open their eyes and say, "What happened?" This expectation is normal.

When the brain ceases to function, the person is permanently unable to think, breathe, see, hear, or feel. They are no longer the person you once knew. Without oxygen, the heart stops beating and vital organs such as the kidneys and liver are unable to function. Medical equipment, such as the ventilator, can keep the heart and other vital organs functioning after the brain has died. Without the machine, the person would not breathe on their own and their heart would stop beating within minutes. The following questions will help you better understand organ and tissue donation.

What is brain death?

A severe head injury or brain hemorrhage (bleeding) usually causes brain death. When the person initially receives emergency treatment they are connected to a ventilator to maintain breathing until further assessment can be made of the person's condition. The determination of brain death is made only after a thorough evaluation in which numerous tests are done. In Virginia, brain death must be determined by two physicians, one of whom must be a neurospecialist. The physicians determining brain death are in no way connected with the transplant team nor can they, by law, perform the organ recovery or transplantation.

Who can donate organs?

The option of organ donation is most often offered after brain death is declared. Persons who die of brain death are maintained on a respirator, which, in turn, allows the heart to continue to pump blood through the organs, which is necessary for organ recovery. In some situations involving severely injured or ill patients who are not brain dead, the option of organ donation may be offered after the family has already decided to withdraw life support.

The age of a donor is less important than physical condition. Each organ is evaluated individually. In general, there must be no history of chronic disease, infection or cancers (except brain tumor). Organ donors may also donate tissue.

How are the vital organs used?

HEARTS - are transplanted into persons with severe heart disease; in the event the whole heart can not be transplanted, the heart valves can be used for children and adults with defective valves.

KIDNEYS - are used for persons on dialysis with chronic kidney failure.

LUNGS - are used for persons with severe lung disease.

LIVERS - are transplanted into persons with liver failure as the result of cirrhosis or other liver disorders.

PANCREAS - can be used to treat diabetes.

Who can donate tissue and how is it used?

LifeNet Health evaluates deaths resulting from causes other than brain death for potential tissue and cornea donation. The transplantation of heart valves, skin, bone, corneas, and other tissues can restore thousands of people to normal, active, and productive lives.

SKIN - is used as a protective covering for extensive burn victims.

BONE - can be used for reconstructive or replacement for persons with traumatic injuries, cancer or bone disease.

CORNEAS - can restore sight to those suffering from injuries or diseases of the cornea.

OTHER TISSUES - nerves, bone marrow, veins, and ligaments can be used for a variety of disorders.

What happens once your decision to donate has been made?

Donor evaluation will be required for all families consenting to donation. The testing includes an extensive medical and social history and multiple laboratory tests to rule out the possibility of infection or other problems that may prevent transplantation. Hepatitis and AIDS screening are routinely performed on all donors. Families requesting results of these tests should discuss this with their transplant coordinator.

While testing is being done, the person must be maintained on the ventilator until after the organs are recovered. This may take several hours. Recipients are then located and transplant teams assembled.

Physicians in the operating room perform recovery of the organs. Your loved one is treated with respect and dignity the entire time. The transplant coordinator notifies you once the procedure is completed. Decisions not to donate are honored and respected. Your physician and hospital personnel help you with further arrangements.

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