Organ Donation

An ICU patient with a devastating, irreversible brain injury may become a potential organ donor. Donation, however, never determines whether or when death has occurred. The clinical sequence is deliberately separated: recognize a potential donor, notify the provincial or territorial organ donation organization, complete an independent death determination, and then support organ perfusion while suitability, consent, matching, and recovery are coordinated. Canadian practice uses one brain-based definition of death: permanent cessation of brain function, shown by absent consciousness, absent brainstem reflexes, and absent capacity to breathe. Death may be determined by neurologic criteria or after arrest of circulation; these are two routes to the same definition, not two different types of death. After death is pronounced, nursing care continues, but its purpose changes from trying to restore the patient to preserving organs and supporting the family through the donation process.