Identifying the Potential Donor

The criteria for organ and tissue donor selection is as follows:

Brain Death Criteria

  • Maintained on a ventilator
  • Heart continues to beat

Donation After Cardiac Death Criteria

  • Maintained on a ventilator
  • Not brain dead
  • Family and physician have decided to discontinue ventilator support

Patients who meet the criteria for brain death or donation after cardiac death (DCD) are potential donors for the following organs and tissue:

  • Organs: heart, heart/lung, lungs, liver, kidneys, pancreas, small intestine
  • Tissue: corneas/eyes, heart valves, skin, bone, tendons, cartilage

Patients who reach cardiac death - no cardiac or respiratory activity - are potential tissue donors only. Each donor is evaluated on a case-by-case basis due to variable transplant center criteria.

Signs of Imminent Brain Death
The following are signs of imminent brain death:

  • Ventilator dependent
  • GCS of 4 or less (per CMS guidelines)
  • Plans to discontinue ventilator or pharmacological support
  • Three or more clinical signs:
  • Pupils fixed and dilated
  • No cough
  • No gag reflex
  • No spontaneous respiration
  • No purposeful movement in response to noxious stimuli

Glasgow Coma Scale

 

Component

Response

Score

 

Eye Opening

Spontaneous

4

To verbal command

3

To painful stimuli

2

None

1

 

Verbal Response

Disoriented

5

Inappropriate words

4

Incomprehensible

3

Sounds

2

None

1

 

Motor Response

Follows Commands

6

Localizes pain

5

Withdraws to pain

4

Decorticate posturing (Flexion)

3

Decerebrate posturing (Extension)

2

None

1