In the case of a patient who has sustained a severe brain injury or insult, every effort is made to save the patient’s life and determine if they have a chance for recovery.  If the conclusion is made that the patient’s condition is incompatible with life, the possibility of brain death must be explored. Two Physicians who are not associated with the OPO perform a series of clinical tests to diagnose if brain death has occurred. Brain death is a legal definition of death, and is the complete and irreversible cessation of all brain function. 

During the period of testing for brain death, the patient remains on a machine called a ventilator that “breathes” for them.  Special medications are administered to maintain the patient’s blood pressure.  However, in the case of brain death, the patient’s body can only be sustained in this manner for a short period of time.  Once the tests for brain death have been completed, the patient is pronounced dead.  The time of the second brain death declaration is the time that will appear on the patient’s death certificate. 

At or near the time of brain death, the hospital staff notifies the OPO and the Donation Coordinator.  The Coordinator will gather the medical information necessary to determine if the patient is a candidate for organ donation.  The donor registry is consulted to determine if the patient has made a decision about donation.  If the patient is not a registered donor, the Coordinator provides the patient’s family with the option of organ and tissue donation.  All attempts are made to determine if the patient had previously discussed their wishes to be a donor with their family.  If the family consent to the donation, they must sign a consent form and provide a detailed medical and social history of the deceased to the Coordinator.

An intensive evaluation of all potential donors is performed to determine medical suitability for donation.  This includes a thorough review of the hospital chart, a physical examination, and a series of laboratory tests.

Donated organs are matched to potential recipients based on a number of factors. These include but are not limited to: blood and tissue type, severity of illness, time on the waiting list, and geographic location.

The patient is brought to the operating room (OR) where the organ recovery will take place.  The OR team consists of Surgeons, OR Personnel, Donation Coordinators, and Organ and Tissue Recovery Specialists.  The organs are surgically removed under sterile conditions in a procedure that usually takes 2 to 4 hours.  The organs are preserved and kept viable until they are transplanted, usually within a few hours. Once organ donation has occurred, tissue donation may follow.  The recovery staff gives careful consideration to funeral arrangements made by the next of kin. In fact, donation does not interfere with the next of kin's wish to have a funeral with a viewing.

After all donation has taken place, the patient is transported to the funeral home chosen by the next of kin or to the Medical Examiner's office, if an autopsy is necessary.

The organs are transported to the appropriate transplant hospitals and the organ transplants are performed. 

While organs are transplanted as soon as possible, some within 4-6 hours, tissues such as corneas may be transplanted days later, and bone grafts and heart valves may be stored for many years until they are needed.

When the donation process is completed, the Coordinator contacts the family and the hospital staff who were involved in the donation to thank them for their assistance.