Organ Donation – Questions and Answers

Organ Donation – Questions and Answers

Brain Death and Organ Donation

The number of patients with irreversible organ failure is increasing day by day. Kidney Transplantation is the most common transplantation surgery in Kerala, followed by liver transplantation. In kerala majority of donors for liver and kidney are live donors as opposed to the western world where majority of donations happen from brain dead donors. There are a significant number of liver and kidney failure patients who will not have suitable donors for medical reasons. These patients and the ones waiting for heart, lung, pancreas and intestinal transplantation can receive organs only from deceased donors.

Complete cessation of all brain function is called brain death. All functions of body are controlled by the brain, so once the brain function is lost that will lead to death of all organs. But the heart has its own pacemaker and can keep beating for a short period even without the signals from the brain. The heart will continue to beat in these patients for some time if the patient is on artificial respiration by a ventilator machine. But heart will stop beating eventually after a few hours or days. This period between the cessation of brain activity and and the cessation of the heart beat is the time where organs can be donated. Mainly there are four reasons for brain damage. Accidents, Tumor, Hemorrhage and block in the blood vessels.

Q: What is the difference between a normal death and brain death?

A: Heart stops beating first in normal death. This will lead to the arrest of blood circulation in the body and the pulse and BP will be absent. All organs will become nonfunctional once the blood circulation is lost. Only cornea can be donated after normal death.

Q: How is brain death confirmed?

A: Brain death is confirmed after several clinical tests. A team of doctors will repeat these tests. Example of the tests are:

  1. These patients will not breath normally. Ventilator support is required.
  2. These patients will not appreciate or respond to pain
  3. All brain reflexes will be absent
  4. Pupil reaction will be absent.

Q: Is there a possibility of patient coming back to life after brain death?

A: No. Once the brain death is confirmed after performing the above tests, the patient will never come back to life again. A team of doctors will perform these tests two times 6 hours apart to confirm brain death. The team include Neurologist / Neuro-surgeon, Treating doctor, Chief medical officer of the hospital and an authorized specialist from a government panel.

Q: Why other organs are functioning even after brain death?

A: These patients are on ventilator support. The heart will continue to beat for some more time even after brain death as the heart has its own battery. If the heart is beating, circulation is maintained and other organs will function. But heart will stop after 48-72 hours usually.

Q: Is it possible to cerate a brain death artificially in a patient?

A: No. Brain death cannot be created artificially with any machines or medicines. Brain death is a spontaneous phenomenon which happens rarely (one or two in hundred). It is easy to stop the function of heart but to create brain death is not possible.

Q: Are Brain death and coma the same?

A: Brain death and coma are completely different. Coma patients are not brain dead at all. Patients in comma can usually breath on their own and will have the brain reflexes intact. If we perform the above mentioned tests of brain death, they will all be negative. Patients in coma are alive as you and me and will not be considered for organ donation at all. On the other hand brain death means death.

Q: What are the contraindications for organ donation?

A: Cancer, Severe Infections and diseases transmitted via blood are generally the contraindications for organ donation.

Q: Is there an age limit for organ donation?

A: There is no age limit for deceased donor ( Donation after brain death). But age limit is there for live donors (Donation from a live person).

Q: What are the organs that can be donated?

A: Liver, two kidneys, heart, pancreas, lungs, small intestine, two corneas are usually donated from a deceased person. Cornea can be donated even after the normal death.

Q: Is blood group matching required for organ donation?

A: Yes. The blood group matching is required for organ donation. In a deceased donor donation the government body overseeing the transplant program in the state will allocate the organs to patients waiting for organs according to the blood group.

Q: Is smoking and habitual use of alcohol are contraindications for organ donation?

A: No. Provided the organs are functioning well they can be utilized for transplantation

Q: Is there any extra expense incurred by the donor's family for donating the organs after brain death ?

A: No. The expenses for all procedures related to organ donation are borne by the hospitals.

Q: Will the body become mutilated after organ donation?

A: No. Cornea donation is a simple procedure and cannot be recognized while viewing the body. For other organs there will be an incision on the abdomen. This will be closed with stiches like other surgeries.

Q: Who has to give consent for organ donation after brain death?

A: The consent has be given by the person lawfully in possession of the dead body. This will be a close relative

Q: In which hospital the deceased organ donation is possible?

A: As per the Government Orders issued in 2012 deceased organ donation is possible in every hospital having more than 50 beds and an operation theater facility

Q: Is there any option to pledge to donate the organs after death?

A: Yes. This can be done in online through the website of KNOS (www.knos.org.in). It is more important to inform your wish to your relatives than signing the form.

Q: If I register as a donor, will it affect the quality of medical care I receive at the hospital?

A: No, most certainly not. Every effort will be made to save your life. Organ donation will be considered only after brain death. In fact, all the doctors would make an extra effort to save your life for as a donor your life is precious for all. Blood and organ donors are respected much more in hospitals, should they fall ill.

Q: How much time is required to remove the organs after brain death?

A: If the relatives are willing for organ donation the first step is to complete the legal formalities of brain death certifications. This will take 7-8 hours. The operation to procure the organs will take 5-6 hours. Cornea donation will take only half an hour. This can be done at the house of the donor also, if the death happens there.

Q: Is there any misuse possible once the relatives donate the organ after brain death?

A: No. The allocation of organs after brain death is controlled by Kerala Network for Organ Sharing (KNOS). This allocation is very much transparent. The list of patients who are waiting for organ in various hospitals is published in their website. Organ allocation is done as per this list.