BRAIN DEATH AND ORGAN

TRANSPLANTATION

V.JEEVAGAN
World's First Human Heart Transplant

Groote Schuur Hospital, Cape Town

 I disconnected the respiratory support being
given to the potential donor and waited until the
heart stopped beating before removing it and
transplanting it into the recipient
 Marius Barnard
It was a lie. Dr. Bernard had injected potassium in Denises
heart to paralyze it, making her dead by the current criteria
on death.
The First Organ Transplant from
a Brain-Dead Donor
Alexandres Criteria
Precondition
Severe Craniocerebral injury

All five Criteria should be met

Complete bilateral mydriasis
Complete absence of reflexes
Complete absence of spontaneous
respiration
Falling blood pressure
A flat EEG
Guy P. J. Alexandre
Evolution of definition of brain death
Americans question the British way of
death
Diagnosis of brain death
Cause of brain non-function must be
inherently irreversible

Vital structures of the brain necessary to

maintain consciousness are damaged beyond
all possible recovery
Clinical criteria of brain death
1. Coma

2. Absence of brainstem reflexes

3. Apnea

A patient determined to be brain dead is legally

and clinically dead.
Ancillary tests
Pitfalls in brain death determination
Failure to address confounders

False positive and false negative signs

Failure to look for alternative options for

organ donation
Donation after cardiac death (DCD)
Complex spinal reflex
Raising of Lazarus Lazarus reflex
Pitfalls in brain death determination
Failure to address confounders

False positive and false negative signs

Failure to look for alternative options for

organ donation
Donation after cardiac death (DCD)
Motivating people.