Organ Donation - Brain Death Diagnostics

Organ donation from the deceased: brain death diagnostics

The prerequisite for carrying out an organ removal is the determination of death by a doctor. If the brain remains without blood and oxygen supply, brain cells begin to die off after a short time. After just a few minutes, the brain functions are irretrievably lost. Intensive medical measures make it possible to artificially maintain ventilation and circulation and thus guarantee the blood supply to the organs. If, however, the entire function of the cerebrum and cerebellum as well as the brain stem has irretrievably failed, then brain death has occurred. Brain death is certain human death.

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• Coma and Brain Death: The Differences
• Diagnostics of brain death

Causes for the irretrievable loss of brain functions are for example

• Cerebral hemorrhage,
• severe head injuries (traumatic brain injury),
• Brain tumors,
• Respiratory failure or
• Cardiovascular arrest.

Coma and Brain Death: The Differences

If there is a coma, the brain functions are partially preserved and detectable. In brain death, all functions of the brain have irretrievably failed. This failure can be proven by a series of special examinations (e.g. electroencephalography).

Diagnostics of brain death

The death of a person must be determined by a doctor who neither removes the organ nor does the transplant and who is not involved in or affected by these interventions.

The determination of death is based on the state of science. In order to standardize the procedure, the Supreme Sanitary Council (OSR) developed and published recommendations for determining death.

Brain death is determined using a fixed sequence of different examinations: If there is primary (e.g. traumatic brain injury, cerebral hemorrhage) or secondary brain damage (e.g. insufficient oxygen supply after cardiac arrest), the previous history and findings of the person affected are recorded. Before starting brain death diagnostics, it must be ruled out that the test results could be falsified by the effects of drugs or other substances.

There are two clinical examinations. The lack of consciousness and the absence of all brain stem reflexes (e.g. no pupillary reaction to light) are checked and the apnea test is carried out. This is followed by additional examinations, primarily electroencephalography (EEG), with which the electrical inactivity of the brain can be measured and shown graphically. The test results are precisely documented. With the diagnosis “brain death” the death of a person is clearly established.