Unexpectedly finding oneself in a hospital and receiving the worst news possible about a loved one leaves most of us feeling shocked, overwhelmed and confused. Our desire is to be available to provide information and support.
We support potential donor families in their time of loss, lead them sensitively through the donation process, coordinate the recovery of organs and tissues for transplant, and provide after-care support.
Understanding Death Terminology
Two ways of declaring death
Cardio-pulmonary death occurs when the heart and breathing stops and a person cannot be resuscitated. This is how most people die.
Brain death occurs when someone sustains a brain injury that permanently stops the flow of blood and oxygen to the brain. When the brain dies the person is permanently unable to think, breathe, see, hear, or feel. When someone’s brain dies pain and suffering ceases.
Physicians will run various tests to determine and confirm brain death and rule out any other conditions that could be causing the brain not to function, such as other medical conditions, medications, or extreme cold. If tests determine brain death occurred the doctor records the time of death while the person is still on the ventilator and their heart is still beating.
The diagnosis of brain death may be difficult for some people to comprehend. It may look as if the person is sleeping because the ventilator fills the lungs with oxygen and helps keep the skin color normal and warm. Sadly, they are not sleeping, brain death is death, it is irreversible and there is no chance for recovery.
Keep in mind; only after all possible efforts to save a patient’s life have failed and a physician has certified, brain death occurred, will organ donation be considered as an option. When someone is pronounced brain dead one of the distinct opportunities people have is to give the gift of life through organ donation.
Once the donation process has begun, it is not unusual for families to have additional questions or need continuing support. ARORA is committed to maintaining open communication throughout the donation and beyond.
Phase 1, Testing
After death has been declared, the Authorization and Medical History are completed, tests will be conducted to determine what organs are suitable for transplant. These organs are heart, lungs, liver, kidneys, pancreas, and intestines. Each organ requires a specific set of tests in order to determine eligibility. During testing, the donor must remain on a ventilator so that the organs continue to receive blood and oxygen and remain healthy as possible for transplantation. Laboratory tests, are routinely performed on all donors in order to prevent the spread of infectious diseases to recipients, such as hepatits and HIV. The next-of-kin will be notified of any positive results.
Phase 2, Placement
Once laboratory results show that an organ meets criteria for transplant, the ARORA coordinator will then work on finding recipients for the organ. A computer listing of all patients in the United States waiting for organ transplants is kept by the United Network for Organ Sharing (UNOS). During this phase of the process, UNOS is notified and a computer list of potential recipients is generated. The recipients are ranked by medical urgency, degree of match to the donor, and time on the waiting list. Each organ is allocated according to specific medical criteria and is not based on race, gender, age, income or social status. ARORA will make every attempt to transplant your loved one’s organs. However, because of current or preexisting medical conditions, we may not be able to transplant all of the gifts that have been authorized. In some cases, organs that are not transplantable can be donated for medical research. ARORA works with a variety of reputable research organizations throughout the country. An opportunity to donate to medical research is invaluable in that it leads to new therapies, procedures, and medicines that will improve health and save lives.
While the coordinator is working on finding recipients, the donor’s vital signs are monitored by the coordinator and hospital staff. Blood pressure, heart rate, urine output, and ventilator settings are all important to ensuring the viability of the donor’s gift for transplant purposes. Throughout this process, the donor remains in the ICU.
Phase 3, Recovery
Once all organs are placed for either transplant or research, a time is scheduled for the recovery in the OR. Many times, transplant surgeons from other states will need time to travel to the hospital for the recovery. ARORA will coordinate an OR time based on when all surgeons can arrive at the hospital. The operation to recover organs occurs within the donor’s hospital. Typically, there is a single incision (similar to open heart surgery), which is closed and stitched at the completion of the recovery. After the organs are recovered, the transplant surgeons will return to their base hospitals to perform the transplant. Following the organ recovery, the ventilator is disconnected. At all times, the donor is treated with the respect and dignity that would be given to any patient undergoing an operation.
The organ donation process may take up to 36 hours.
ARORA’s organ procurement team coordinates with our tissue recovery team for the next step in the donation process, or if the donor is not a tissue donor, with the funeral home.
Tissue and Eye Donation
Potential tissue and eye donor candidates are referred to ARORA by hospitals and coroners once death has occurred. ARORA screens the patient’s medical history to determine suitability. A representative from ARORA will then contact the family for authorization for tissue and eye donation. Once authorization is obtained, ARORA coordinates the transportation to the ARORA Recovery Suite for the recovery process.
In cases where the tissue donor is also an organ donor, the authorization is completed at the same time as the authorization for organ donation and the recovery takes place either in the OR or at the ARORA Recovery Suite immediately following organ recovery. The ARORA tissue team coordinates with Arkansas Lions Eye Bank for any authorized eye donors. They send their own team to recover eyes for corneas following the tissue recovery.
A single tissue donor can touch the lives of numerous people through the donation of corneas, bone, skin, veins, tendons, ligaments, and heart valves.
Tissue is used to replace bone, tendons, and ligaments in people with cancer, joint disease, arthritis, and traumatic injury.
Bone is used in a variety of orthopedic procedures as well as bone transplants that can help one avoid amputation.
Heart valves are used to help reconstruct the poorly formed heart of a child or to replace a diseased or damaged heart valve of an adult or child. Donated vessels and valves can mean the difference between life and death to the recipients.
Veins and arteries are recovered for transplantation to repair and restore circulation. Donated vessels are used to restore circulation in heart bypass surgeries and to avoid limb amputations.
Skin can be used to aid in recovery from burns, hernia repairs, and breast reconstruction following a mastectomy.
Corneas help to restore sight to those suffering from injury or disease of the cornea. All eye donations are coordinated and performed be the Arkansas Lions Eye Bank.
Organ and/or tissue donation does not affect the ability to have a viewing or a funeral.
Release of the body
After the organ and/or tissue recovery has been completed, the body will be released to either the medical examiner (ME) or the funeral home of the family’s choosing. If the donor has been transported to ARORA for recovery, ARORA will provide transportation to the funeral home.
Following organ and/or tissue recovery, the family will receive information regarding ARORA’s after care services. These services include writing letters to the donor family informing them about the individuals who received their loved one’s organs, while maintaining confidentiality of both donor and recipient families; the ability to participate in events held by ARORA to honor donors and donor families; and participation in the Donor Family Council. ARORA also has an active volunteer program, where donor families have the opportunity to become further involved.
Statistics and Additional Information
Less than 1% of all deaths meet the criteria to donate organs.
• Less than 10% of all deaths meet the criteria to donate tissue.
• There are currently over 100,000 people in the USA in need of a lifesaving organ transplants.
• Up to 17 of those people die daily waiting for a transplant.
• Normal funeral arrangements can still take place after organ or tissue donation.
• Because donation is truly a gift, Arora assumes the cost of the donation process.
• Arora works closely with medical examiners, coroners, police, and prosecutors to ensure that donation does not interfere with criminal investigations.
• One donor can potentially save or enhance the lives of more than 100 people.
“It was the only sane thing to do during an insane time. Diane spent her life helping children with multiple handicaps. I know she would want to help people during her time of death. I am thankful for the 17 years I knew and loved Diane. She was an amazing lady.”
“Without all the wonderful people at ARORA, I can’t say what would have happened to me. You were not only there for us when we lost Blake, but also there for us when we lost Bradley. Thank you all for the support that you have given and continue to give to me and my family.”
“When Maclaine was born, we expected to add one to our family. When she died at three days old and was able to be a donor, with the support of the ARORA staff and the friendship of other donor families and the gratitude of her recipient and family, we now have hundreds more that we are honored to call family.”