Do you trust the organ donation process (after recovery of 'brain dead' boy)?

meanmaryjean, DNP, RN · May 10, 2018

I had a very sketchy experience with a donor organization years ago that put me off the whole "industry".

Sour Lemon · May 10, 2018

You must have seen the story of the teenager with the head injury who was pronounced by doctors as being ready for organ donation. Fortunately he started waking up the day before harvest was to commence.
Boy 'regains consciousness' just after parents agree to let doctors turn off life-support machine | The Independent
Personally, I've always been leery of the organ donation biz. This story reinforces my paranoia and distrust.

Was he actually declared "brain dead", though?

Emergent, RN · May 10, 2018

Was he actually declared "brain dead", though?

They were planning on pulling the plug the next day, so I presume they had determined his eligibility.

Sour Lemon · May 10, 2018

They were planning on pulling the plug the next day, so I presume they had determined his eligibility.

I didn't read anything that suggested he was brain dead or had been declared so. I did read that he had a brain injury and that his prognosis was not good. You can "sign papers" to be an organ donor at any point.

His family do not appear to be medical professionals and are fundraising on top of that. A sensational story gets press and press brings in donations. I also believe they may be "filling in the blanks" where their understanding is lacking.

To answer your question, I do still believe in the process and I am an organ donor myself.

Ambersmom, BSN, RN · May 10, 2018

I've never really trusted it, we had a rep come to class and say conflicting things that really put me off it, plus my own personal beliefs conflict. I've heard more than one story of a supposedly brain dead person waking up.

TiffyRN, BSN, PhD · May 10, 2018

The story I read (and all were from the family's perspective), discussed how the kid started to fail the testing for brain death the day before planned withdrawal of life support. I think that raises my confidence in the process. They were going through the needed exams, and the kid failed, which showed brain activity. Good. And huge skepticism over his eyes changing color because they "saw God".

My guess, the steroids kicked in, reduced brain swelling enough to allow sufficient perfusion, and he never totally lost brain function. Yay science. Not a miracle.

guest769224 · May 10, 2018

As an ICU nurse, I have cared for several donor patients. Including the process of the initial order set which is very tedious.

That said, I too am leery of the industry and have elected not to be an organ donor.

I feel like as nurses, it's almost expected to be a donor. I may be wrong about that, but it shouldn't be that way.

ThePrincessBride, MSN, RN, NP · May 10, 2018

As a black person....I refuse to put myself on the organ donation list. Medicine has a history of giving black people substandard care..I wouldn't be shocked if I come across horror stories of minorities getting poor treatment due to having great organs to harvest. I want them to do everything possible and I am afraid some prejudiced doc wouldn't.

PeakRN · May 10, 2018

I don't see anywhere that states that the patient was actually brain dead, that has much more stringent criteria than placing a patient on comfort care and removing life support. They intensive care team may have been having discussions about withdrawing care and concern for long term disability before any kind of diagnosis of brain death. I'm a bit suspecious that the story being told may not be entirely accurate.

Some of this may have to do with different organ procurement organizations but ours is great. They want to be notified if there is any chance of brain death, there is a lot of planning that goes into organ procurement so that the recipient can have the best possible outcome. Our OPO would rather send out a team and cancel it than to have a potential donor organ be wasted. Bowel and lung transplants are especially time sensitive so the more planning the better the outcome.

As a hospital that performs a lot of BMT and solid organ transplants it is amazing to see the difference it can make to patient's lives. Seeing mothers who get to raise their children, young adults who are able to climb 14ers again, teens who don't need to dialysis three times a week, and babies who are no longer slowly dying of a terminal lung disease can really shape how you see the organ donation process.

I can understand how it seems like OPOs are there just to take organs but it is with the best of intentions to help the recipients, not to in any way hurt donors or their families. I hope to live long enough that my organs aren't useful to anyone, but I were to die before that time then I hope that I could make that kind of difference for someone else and their family.

applewhitern, BSN, RN · May 10, 2018

The article I read in our newspaper was from the family's perspective, not any medical people associated with his care. I thought perhaps the family simply misunderstood the difference between a coma, a brain injury, and brain death. With the recent UK case of the toddler who was brain dead, the family probably had the term "brain dead" on their mind, and thought it was all the same.

MunoRN, RN · May 10, 2018

A number of the news articles do claim that the child was officially "brain dead", but then contradict that in the details of the article. Many of the articles reference that on the day he started to wake up, he was supposed to have brain function testing done later in the day that was then cancelled, so clearly not yet declared brain dead. Another stated that what I presume was the apnea test the child was "barely breathing", which is not brain dead.

It sounds as though they were pursuing Donation After Cardiac Death (DACD), which is different from the beating heart donation that occurs with a brain dead patient. I do have issues with DACD which is relatively recent form of donation. In many cases there are no issues and it's clear withdrawal of life support followed by organ harvesting is the best possible outcome, but sometimes the donation organizations and their staff can be a bit predatory and vulture-like.