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Organ donation

 

Brain death and organ donation

 

Encephalic death is the death of the brain, a total cessation of cerebral activity necessary to maintain vital functions.
Encephalic death is not a coma, but an irreversible state. In France, its diagnosis is strictly regulated by law, and includes a series of tests
that leave no room for doubt. During the diagnostic period, and the time required to ascertain the deceased's wishes concerning organ donation, vital functions are maintained in order to preserve organs suitable for transplantation.

This is why encephalic death can be confusing for loved ones: as the patient's breathing and circulation are maintained artificially, the deceased still has the appearance of life.

 

Criteria for the Diagnosis of Encephalic Death


In France, the diagnosis of encephalic death requires the simultaneous presence of three clinical criteria:

  • Total absence of consciousness and motor activity (movement)
  • Absence of all brainstem reflexes
  • Total absence of spontaneous ventilation

This is followed by a paraclinical examination to confirm that death is irreversible:

  • Or two null and reactive electroencephalograms (performed 4 hours apart)
  • Either an angiogram showing cessation of brain circulation

The declaration of brain death is then made by two doctors, and the death certificate is signed by both of them.

In the case of brain death, it is possible for patients to donate their organs so that they can be transplanted into seriously ill people to enable them to survive.
Today, in France, almost 95% of organs taken for transplantation are donated from people in a state of brain death, but certain organs can be
donated during the patient's lifetime (e.g. kidney donation, bone marrow donation). Certain tissues, such as corneas, can also be donated, even when the patient's heart has stopped.

If organ donation is an option, a member of the intensive care medical team or the transplant coordinating nurses will contact you to find out your loved one's position on organ donation.
They will be there to explain the situation and the steps involved in a clear manner, and to answer any questions you may have.

Any decision concerning organ donation is always taken with the greatest respect for the values, beliefs and feelings of the deceased and his or her loved ones. Whatever the final decision,
the deceased will receive the best possible care, and the team will do its utmost to accompany and support you.