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

[Emergent]

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.

[elkpark]

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

Many, many families discontinue life support on individuals who are not brain dead; that is not the only criteria for doing so.

But feel free to enjoy your conspiracy theory.

[KatieMI, BSN, MSN, RN]

I've dealt with dozens of patients whose families could tell pretty much word by word the very same story sans organ donation part. The truth was that most of those patients had severe residual functional defects. The best outcome was part independent ADLs on multiple anti-seizure and other meds, and a few were on that prolonged torture otherwise known as "chronic life support" with GCS 7+/- 2. Yet, the families were sure that they were doing "just great" and were "on their way to full recovery" and attempted to enroll one of them in full time university undergrad course, among other things. So, I tend not to believe miraculous stories from elated family members who see and hear strictly what they want to see and hear.

I am an organ donor and DNR if over 96 hours on vent under any circumstances. I saw too much in my life and would prefer eternal rest (and potentially saving someone on my way there) over what it REALLY means to be "recovering from anoxic brain injury" of even moderate degree.

BTW, for those who are afraid to be given second-line care as potential donors: transplant surgeons are known, among other things, as people insanely obsessed with, that is to say, "quality of material" they work with. These surgeries and their results mean too much for them, even if they can forget (and they never can) about legal risks which will fall heavily on them in case of bad outcome. Transplant centers are closely watched for their outcomes as well and compete with each other to death because, although by themselves transplants do not bring much $$ (as most patients are on Medicare/Medicaid and the costs are tremendous), but associated research, teaching and status changes bring royal $$$$$ and Pharma and professional association's people can pick and choose the best. Therefore, there are too many folks who are VERY interested in the highest possible quality of care for patients who look like potential donors, and these people are on the level to have what they want to get done. I tell that as one who worked in transplant research for a while and saw it all from provider's side.

[Guest219794]

"Man Agrees To Donate Organs, Then Works a 12 Hour Nursing Shift."

Yup, just signed my organ donor card, now I am heading to work.

I am not sure I understand the story.

It looks like:

A family discussed withdrawl of life support in a critically ill patient, pending further testing and evaluation.

The patient had a poor prognosis, and the family discussed organ donation. Had the child died, this might have saved other children.

Despite expectations, the patient recovered.

At that point, they decided not to harvest any organs, as the patient would still be using them. Ideally for quite some time.

What am I missing?

[KatieMI, BSN, MSN, RN]

"Man Agrees To Donate Organs, Then Works a 12 Hour Nursing Shift."

/QUOTE]

YOU MADE MY DAY! (now running to OR to steal some scrubs, as my designer trousers are off use)

[Guest219794]

Kind of a follow up:

Although the article I read did not indicate that anything had been done wrong, let's say, for discussion, a mistake had been made.

Mistakes happen.

There was a heartbreaking case a few years ago in which "A nurse, who was cleaning up, had just returned from a lunch break and thought the kidney was already in Sarah's room when she discarded the machine's contents".

While this is certainly a call to improve the process to reduce errors, it would not stop me from donating a kidney to a loved one.

Indicting a whole medical field for a perceived error is like throwing the baby out with the bath water. Or throwing the kidney out with the ice water.

[brownbook]

The lyrics, "Wake me, shake me, when it's over", keep running through my head.

I am a donor.

[Emergent, RN]

This article has more imput from the mother regarding the sequence of events.

American boy wakes up after being declared brain dead

None of the articles I've read have appeared to be alarmist in nature, but I do find it troubling that the doctors were so off.

Putting blind faith in the medical system is foolish, in my opinion. And saying I'm a believer in conspiracy theories for bringing this subject up is, frankly, insulting.

[ICU-BSN]

The article is the mother's perception of events. Medical staff were not interviewed, making it a biased report. Also, it states that the boy was scheduled the next day for the final brain wave testing to indicate brain death; this test was cancelled after he began to wake up.

The physicians in this case were wrong when they said he would have no meaningful recovery. In this situation I would rather be told to prepare for the worst and have the best as the actual outcome, rather than be told everything will be great when in the cases of so many TBIs there isn't meaningful recovery.

OPOs are brought in fairly early to evaluate potential donors, however they can NOT just take organs without consent, which some responses are making me feel some here believe.

I have cared for many donor patients, and have even gotten to go into the OR for the organ recovery process. I consider it a great honor to see this patient through the process, I treat them the same as any other patient, even talking to my brain dead patients.

I also have witnessed the amazing gift that organ donation is to those in need. Truly life changing.

I am a donor, and I would make that decision for any of my family members if the situation arose.

[/username, BSN, RN]

Yes, I do trust the process... Having both professional and personal experience in this area, there's really nothing to hide, and really the most drama comes from posts and stories like this that are rife with misinformation and conspiracy theories. With the small handful of sensationalized stories like this, either two things happen. They were never actually declared brain dead (like this article), or the brain death declaration was done in error as there was some confounding factor that mimicked brain death (hypothermia, drug intoxication, alcohol intoxication, hypotension, electrolyte abnormalities, inexperienced clinician declaring, etc). This does not mean that the person "recovered" from brain death. It means that they were never brain dead in the first place. The majority of these erroneous declarations occur as a result of drug/alcohol intoxication, hypothermia, and hypotension.

There has not been a single documented case in the entire world where someone was properly and accurately declared brain dead who recovered. if there was, it would be in every medical journal, and on every single news outlet for weeks...

Like anything else in life, when someone, or a large portion of the population doesn't know about how something works, it opens up a huge opportunity for conspiracy theories to develop, and not only are healthcare personnel not immune to this phenomenon, it's happening in this very thread. It's much easier to assume that something shady is happening when you don't know how something works.

If you don't believe me, get in touch with your local donation agency, or talk to them when they're on your unit next. There's nothing to hide about any part of the process, and I'm sure they would be more than willing to let you observe. The only thing that you might not be able to observe is when they are looking for recipients due to privacy concerns.

And to the poster that finds the initial order set to be "tedious", there are certain and very specific things that are needed to both evaluate organ function, and others that have been proven in studies to have better outcomes in recipients. At the point where organ donation is being performed, the focus shifts from trying to save the donor, to having the best outcome for the recipients and donor family. Admittedly, there are many things that the OPO will ask you to do with a donor patient, but just because you don't know the value of it, doesn't mean that anything nefarious is happening.

[xoemmylouox, ASN, RN]

I'm staying an organ donor. Most of these stories are full of lies, misunderstandings, and lack of basic medical understanding.

Do I need to bring on the Jahi McMath story? I haven't heard much about that story lately. I haven't seen and new videos of her communicating, moving on her own, or any other substantial functioning actions. Anther example of there are worse things than dying or almost dying and becoming an organ donor.

I'll take being gone from this Earth vs laying in a bed, completely dependent on machines, for the remainder of my days.

[Emergent, RN]

I'm staying an organ donor. Most of these stories are full of lies, misunderstandings, and lack of basic medical understanding.

Do I need to bring on the Jahi McMath story? I haven't heard much about that story lately. I haven't seen and new videos of her communicating, moving on her own, or any other substantial functioning actions. Anther example of there are worse things than dying or almost dying and becoming an organ donor.

I'll take being gone from this Earth vs laying in a bed, completely dependent on machines, for the remainder of my days.

This boy is walking and talking now, and is continuing rehab at home. He sounds coherent and intelligent in the interview and can read and do math.

The story doesn't necessarily doesn't point to a grand conspiracy, but perhaps an over eagerness to obtain organs and errors in judgment on the part of doctors.

[/username, BSN, RN]

This boy is walking and talking now, and is continuing rehab at home. He sounds coherent and intelligent in the interview and can read and do math.

The story doesn't necessarily doesn't point to a grand conspiracy, but perhaps an over eagerness to obtain organs and errors in judgment on the part of doctors.

I agree that there was an error in judgement from the physician, but that has nothing to do with donation. And while the interview doesn't say there's a huge conspiracy, you better believe that people are using it to push conspiracy theories. Heck, you did just that with the very first post!!!

People die every day because of the need is greater than the supply of organs for transplant. If you or a loved one needed a transplant, wouldn't you want people to be working as hard as they could to get you that life saving gift?