[i]If the brainstem tests are there to prove the person is no longer functioning, how does a person continue to function (even badly) for 16 hours?[/i]
Your heart will continue to beat for a time after brain stem death. Legally, after you have had brain stem tests that show brain stem death, you are considered dead, despite your heart beating.
That's how most donation is done; you are dead, but your heart is still capable of perfusing most of your organs.
Non beating heart donation is sub-optimal in that we wait for the heart to stop, then go ahead, but this is logistically difficult; we know that the heart will stop sooner or later, but we cannot afford to have a transplant team sitting and waiting for potentially a long time.
Our transplant co-ordinator nurse is great; I think I'm good at talking to people, but she puts me to shame.
(and, many years ago, I saw her with nothing on.... close up.... 🙂 )
So the heart can keep beating but without a ventilator and with brainstem death how does this happen for more than a few minutes? Lack of oxygen would surely bring the whole lot to a halt, at least after an hour or so? 16 hours seems like a long time for a heart to keep beating on its own with no oxy supply, and then why dont the hearts of people who've died of other causes (such as drowning) keep beating for hours also despite no lung action occuring? (genuine question, very interesting).
World class accident
this is what happens. Once brain death is declared, if you are on the register then your next of kin would be approached regarding organ donation as you were on the register. If the NOK is in disagreement they dont overule their wishes.
then tissue typing and donor matching is done before organ harvest and transplant procedures.
Our transplant co-ordinator nurse is great; I think I'm good at talking to people, but she puts me to shame.(and, many years ago, I saw her with nothing on.... close up.... )
Did you lend her your organ while you were at it!( vice versa is you are a woman crikey)
BTW where are you based- personal interest re above
Doc - Won't they ask the NOK for my organs anyway?
I think in TJs case the patient must have been still on a ventilator; brain stem tests that reveal brain stem death test for any kind of respiratory drive, the absence of which is one sign of BSdeath.
Sometimes it's a kind of compromise; maybe the family were not in agreement about turning off the ventilator, maybe other family members were travelling to see the patient.
Ultimately, and going back to the concerns expressed, we wouldn't get into any kind of conflict over the death/donation situation; the patient and family come first regardless of any need for organs.
Yes but families are more likely to aggree to donate when they know it was the wish of deceased.
it's a difficult call to make, when linds died and despite us knowing that she was on the register and there being 2 docs there too- me and my wife- my mother in law initially didnt want her organs taken and understandibly her husbands head was in the shed and he didnt know what to do. Sarah and I were both very pro going with Linds' wishes which is what eventually what swung the decision. the right one.
[i]BTW where are you based- personal interest re above[/i]
I can't tell you now I've admitted to naughtiness with the transplant co-ordinator!
East Manchesterish....
On a slightly lighter note - Why don't they just post the question on STW?
We know all the answers.
Post : WCA Dead - Shall we slice and dice him or not?
He has finally died. Do we use the bits left over or toss it into the bin?
Can you imagine the postings on that thread?
don't worry crikey I'm in Wales!
I was wondering if you were in Brum
I wasn't there so I might not have the whole story but as it was told to me the vent was turned off, he was brain dead but the heart did not stop beating for 16 hrs. Perhaps tho it was all other support was removed but he was kept on the ventilator.
All I know is it was awfuly traumatic for the family and his organs were wasted. His organs could have been harvested earlier and it would have been better for his family and the recipients - who ended up with nothing
WCA - given your accident history are any of the bits worth having?
TJ - I have lived this long so you will probably find I have Super Organs. The heart that thrives on 240V shock. The liver that actually needs feeding alcohol on a regular basis. The kidey that do whatr ever the normal kidney does but with more style and faster...
...and just out of 'No way!' kind of interest, I got talking to another recipient transplant nurse ( I wasn't trying to see her close up or naked this time) and she was describing some new technology which allows suboptimal lungs and other organs to be perfused in a kind of Frankenstein stuff-in-a-jar style before being transplanted. The technology is getting better and better, we just need to get people into the idea that donation is a good thing.
I'm still confused regarding this. I'm not allowed to donate blood because I'm in a high-risk group yet they still want my organs.
Surely since they'll be full of blood etc. *and* they need the organs as quickly as possible they shouldn't really want them?
Until this dichotomy is resolved the answer is 'no'. If it is then I'll sign up.
Adam, they will tissue type and test your organs/blood for a variety of diseases before transplant.
They would have to test you and/or your blood everytime you donated it; that's why they're not keen.
I think that the US is doing or at least looking at transplants from HIV donors to HIV recipients, again, the technology is ahead of attitudes...
(I'm making an assumption about the reason you are considered high risk by the transfusion service, which which might be way out of line..)
Hmmm crikey sounds like an intensivist!! 😉
Hi Crikey
No, you're right. Just being gay means you can't donate blood.
You've sort of cleared it up for me - I suppose if something happened to me they could keep my body going while they did tests etc. and gave the thumbs up.
Right, money where mouth is, I'll sign up.
Good call adam
and heres a link to help you along!
http://www.uktransplant.org.uk/ukt/how_to_become_a_donor/how_to_become_a_donor.jsp
I wonder how many new donor registration this thread has prompted?
+1 for me
STW - a power for social good
I'm not an intensivist, just an ITU nurse for about a thousand years. I'm getting more interested in the transplant service though, and not just because one of them once accomodated me for an evening....
One of the main factors in my promotion of organ donation has been my contact with relatives of donors and transplant recipients themselves. They have a passion for the idea of organ donation that burns fiercely, and what they do in terms of agreeing to donation or working to promote transplantation after recieving organs makes me feel very humble indeed.
It really does make a difference, it really does save people from a miserable shortened life and from an untimely death.
Well working in ITU puts you in an ideal position to follow this through crikey. You deal tragedies all the time in itu so you must have the right experience for the job. The nurse in neuro ITU in Brum was amazing as well as the transplant nurse. I'd say a thousand years in itu probably makes you an intensivist!
I seconf your thoughts re organ donation. better off being used than burnt or buried in the ground IMO.
Haven't yet - would accept donated organs therefore should do.
I particularly like old git surreys attempts at donating to young ladies in the local, could be the start of a failed chat up line!
I signed up years ago, but for the same reasons as Junkyard I eventually will not be able to donate. I have been waiting for a new filter (kidney) for 2 years now. I have had just 2 people get tested to be live donors so I will have to wait for some other poor bugger to check out before I can get one. In some ways that day cannot come quick enough but in others I am dreading it:
a- not sure how I will get my head around have a deceased persons kidney in me.
b- it WILL hurt - already had one op and my first words when coming round were OWWWWWW!!!
a couple of links provided below for info:
[url= http://www.pkdcharity.co.uk/ ]My condition[/url]
[url= http://www.uktransplant.org.uk/ukt/about_transplants/about_transplants.jsp ]UK Transplant site[/url]
This seems to be something people always never get round to doing despite best intentions, so sign up if you are willing - it only takes a minute.
How does organ donation work if you want to top yourself? I reckon organs go a bit 'mushy peas' at the bottom of a cliff so they're no use to anyone then.
Can you walk into a hospital and get them to do it for you and in return they can have yer carefully cultivated internal groupset?
Mr sensitive there, I do wonder sometimes....
bananaworld- go to switzerland and pop to dignatas. I'm sure they'll do it for you. Please go.
Nice one DoctorNick 😀
In some ways though, bananaworld is on the right lines...
It should be something we accept and are able to joke about, even in a tasteless fashion, rather than being a taboo subject that only gets raised in the most dismal situations...
I'm trying to find out some info regarding the most number of times a single kidney has been transplanted; I think it's a number more than one...
I wonder how many new donor registration this thread has prompted?
A few, I reckon. Yours truly signed up following a similar thread a few moths ago.....
Also, just had a text - how very Now - to remind me to go give blood next week....
...There's not much info on the web, but it's definitely the case that you can go on to donate the kidney or other organ that you had donated to you, to go on to help someone else.
Which is pretty amazing really...
doctornickriviera - Member
go to switzerland and pop to dignatas.
I've wondered about that actually, but I think they'll only 'do' you if you have some chronic physical ailment. Mere mental disorders are outside their remit, which, for me personally, is a shame.
My kidenys, heart, liver, etc. are in great shape and I'd love them to go to someone who will enjoy life rather than just plodding along like me.
[i]My kidenys, heart, liver, etc. are in great shape and I'd love them to go to someone who will enjoy life rather than just plodding along like me. [/i]
Which is a noble sentiment.. But I'd rather you used them for a while longer, maybe put a few miles on the clock as it were... 😉
Slice and dice me when I go - if I can help someone else then do it.
Why wouldn't you want them to have your eyes?
