Organ donation info giving/shared decision making

What is it?

 the process when a person allows an organ of their own to be removed and transplanted to
another person

What can be donated?

 Heart
 Lungs
 Cornea
 Liver
Organs  Skin bone
 Kidneys Tissues
 Tendons
 Pancreas
 Heart valves
 Multi visceral/small bowel
(DBD only)

Who can donate?

 Donation after brain stem death (DBD; heart beating) or donation after circulatory death
(DCD; non-heart beating)
 Anyone who is intubated and ventilated in a critical care setting (ITU/ED/Recovery) with a
plan to withdraw their treatment with an expectation they will pass away quite quickly
(DCD) OR they meet criteria for Brain Stem Death Testing (DBD)
 From 36 weeks gestation to 85yo

What is brain stem death?

 Irreversible loss of function of the brain and brain stem

 Confirmed by diagnosis of death using neurological criteria (DDNC)
o Fixed and dilated pupils
o No response to painful stimuli (e.g. supraorbital pressure in CNV distribution)
o Loss of cough, gag, corneal and vestibulocochlear reflexes
o Apnoea
 Test 5 mins looking for resp response to rise in CO2
 Must exclude reversible cause e.g. drug
intoxication; hypothermia; metabolic & endocrine
disturbance
o Hypertension followed by hypotension
o Tachycardia/Bradycardia
o Diabetes insipidus – sustained urine output over 300mls/hr
o Reduction in core temperature

What is circulatory death?

 Irreversible loss of function of the heart and lungs

 Extubated with family present and pronounced dead after 5 mins of irreversible loss of
cardiac output