Organ Donation Process
Trauma Scene/Cause of Death – Many organ donors are victims of accidents resulting in fatal head injuries. Other donors are victims of spontaneous bleeding in the brain or lack of oxygen after cardiac arrest.
Transport – A highly specialized medical team of paramedics and emergency medical technicians begin lifesaving efforts at the accident scene. They communicate with emergency room doctors during transport to the hospital.
Emergency Room (ER) – Doctors and nurses have advanced ventilation support ready when a patient arrives at the hospital. Here, they evaluate injuries and continue lifesaving measures, including a respirator (breathing machine), intravenous fluid and blood replacement, and drugs to help the heart keep beating. If the patient's vital signs stabilize, he/she may be transferred to an intensive care unit (ICU).
Intensive Care Unit (ICU) – Here doctors perform special tests to see how much damage has been done to the brain and the body. The medical team continues advanced life-support treatment during these tests.
Brain Death – If the tests done in the ICU show brain activity and blood flowing through the brain, the patient is in a coma. But if tests show no brain activity or blood supply, the brain has been destroyed and will never work again. If the tests show the brain is no longer alive, the doctor approaches the family and explains that the patient has died. See brain death information below.
Understanding Brain Death
Brain death occurs when the brain is severely damaged by trauma or illness. A physician declares brain death when testing determines that there is an absence of electrical activity in the brain, no blood flow to the brain, and no brain function. Without brain function, the rest of the body can't survive. Consequently, a respirator or breathing machine is used to keep other organs functioning – if consent to donate is given – while recipients are located for the donated organs.
Referral/Evaluation – When brain death is declared, a LifeGift donation clinical specialist goes to the hospital to see if the patient is medically suitable for organ and/or tissue donation. The ventilator provides oxygen to the major organs, even after the patient dies, until the family decides about donation.
First-person Authorization – LifeGift will check the Donate Life Texas Registry to determine if the person is a registered donor. If he/she is a registered donor, LifeGift will inform the family that their loved one decided while he or she was living to give the gift of life to someone who truly needs it. LifeGift maintains a legal obligation to observe all end-of-life decisions, including donor designation. The state of Texas recognizes this as a legally binding decision. LifeGift and all hospitals are legally obligated to honor advance directives, including organ, eye and tissue recovery decisions by the patient.
Authorization – After telling the family the patient has died and determining that the patient is a suitable donor, the LifeGift staff member works with the family to ensure that the opportunity to donate is offered to those eligible. Once a family decides to donate, an authorization form is signed by the next-of-kin. Now, the patient is called a "donor." All hospital costs from this point are paid by the organ donation center (i.e., LifeGift).
Organ Placement – When first-person authorization is determined or when next-of-kin authorization is given, the donor's blood type, height, weight and hospital are entered into a national database (UNOS) to find patients awaiting transplants who best match the donor's heart, lungs, liver, kidneys and pancreas. Recipients for corneas (eyes), skin and bones can be found a short time later.
Organ Recovery – A transplant recipient's surgical team then comes to the hospital to remove the donor's organ for the patient. Like other operations, this surgery takes place in an operating room. The organ(s) is then taken to the transplant center where a recipient(s) is waiting.
Funeral Arrangements – After donation, the donor is taken to a funeral home. Generally, funeral services are not delayed by donation, and donation itself does not prevent an open-casket funeral.
Follow-up – About two weeks after the funeral, the donor's family receives a letter from the donation center. The letter tells where organs and tissues went and shares some basic information about the people who received them. Names of donors and recipients are kept confidential, but donor families can get updates about recipients any time by calling LifeGift. Donor families usually enjoy getting letters from recipients so they know how the patients are doing.
Donation after Circulatory Determination of Death (DCDD)
Donation after Circulatory Determination of Death (DCDD) (previously known as Donation after Cardiac Death or DCD) is an opportunity for families of patients who do not meet the complete criteria for brain death to donate organs. It is offered to families once the medical team and the patient’s family have established that the patient will not have meaningful recovery and life support measures will be discontinued. If the family agrees, the patient is moved to an operating room where the patient’s physician withdraws ventilation support. In some situations, support may be withdrawn in the intensive care unit. After the patient’s heart stops beating, the physician declares death. The transplant team waits no less than 5 minutes following pulselessness before starting organ recovery. The lungs, liver, pancreas and kidneys often can be recovered.
Download fact sheet on Donation After Circulatory Determination of Death (DCDD).
Watch this video produced by HRSA about the organ donation process.
Scott Rhoden firmly believes God has a plan for all of us, whether or not we understand it. Scott’s wife, Shellen, always put herself second – even near the end of her battle with Lou Gehrig’s disease. Communicating only through her eye movements, Shellen told Scott she wanted to donate her kidneys to a friend who needed a transplant.
On Dec. 16, 2010, Shellen was prepped for the kidney recovery and taken off life support. Through it all, Scott held her hand and assured Shellen her kidneys would save their friend. And after 26 years of marriage, Scott could tell in one look – his wife smiling on the inside.