Organ Donation

[Giggling Squid]

That sounds harrowing but thank you for explaining. I pray to god I’m never in that situation with someone I love. Can I ask, at what point does the patient die? Is it straight after theatre? Does he die alone, can his family be with him?

I don’t know if it’s always the case, but we were with my dad right into the anaesthetic room before he went into surgery when they turned the machines keeping him alive off. We were with him at the end.

That is NOT a stupid question at all! But nope, not true at all.

There are so many things going on when a severely unwell person is admitted to intensive care, you don’t go “oh they are a donor - Bob upstairs needs a heart, let’s take this one!”. Here’s an example of an organ donation case:

John (he’s pretend) has a bleed on his brain. Intubated and ventilated by paramedics at the scene because he’s completely unresponsive and unable to breathe. Gets admitted to A&E. Scan shows this is a very severe injury to his brain and it is likely he will not recover, however there is emergency surgery that can be done to give him a slight chance. He is rushed to surgery. Then onto ICU. His blood pressure and ventilator requirements etc are all over the place, it takes hours and much medication to stabilise him. Finally when he is semi stable (yet still critically unwell and unlikely to survive / get to a point where he and his family will be happy with his quality of life) conversations are had about where we go from here (this could be days - a few weeks later!). He’s not making any effort to breathe for himself and he is not responding despite not being on any sedation / drugs that keep him asleep. Family say he would not want to live in a disabled or reliant state. Organ donation is not mentioned at this point at all. Family spend time with him whilst in the background we check if he is on the register. If he is then we contact the specialist organ donation nurses to approach the family and tell them that he is and ask their opinions about going forward with donation. They are not forced into this at all, and are given the opportunity to ask a million questions about the process. If he isn’t on the register then we still contact the specialist organ donation nurses to inform them that we have a patient who is heading towards the end of their life and is a candidate for donation. They then approach the family to ask their opinion - ONLY when the time is right (after they have had time to come to terms with the discussions they have had / spent time with the patient etc). If they do not want to donate, the ventilator and medication sustaining life is removed and the patient passes away with his family around him. If they do want to proceed with donation then the specialist nurses do many further specialist tests on the patient to ascertain if he can donate. The family are made aware of all of this beforehand and have to sign consent forms. The results of all the tests are then sent to a central donation hub where the patients organs are matched to people who are waiting for organs. His heart may be matched to someone in Glasgow, his lungs to someone in London and his liver to someone in Newcastle for example. It’s all anonymous and it does take up to maybe 12 hours or so to get all the tests and matches done. During this time the patient is often unstable so the team fight really hard to keep them “alive” as the organs need to be viable. So definitely not being given up on. Once all of his organs (or the ones that are usable anyway) have been matched and then accepted by the receipt, he is prepared for the operating theatre. This is a massive task in itself. The hospital receiving each organ send their own specialist surgeon and team to retrieve the organ, so many surgical teams travel to the patient for the operation. The family say goodbye to the patient, taking handprints and locks of hair etc if they wish, and then the operation is carried out with such care. The organs then travel to their destination straight away. The family of the patient are contacted the next day by the specialist nurses and for a few months afterwards. They are also offered counselling and bereavement care.

It is such a special and heartwarming process to be involved in. Yes it is incredibly sad, but seeing people act so selflessly during their very worst hours is humbling.

I hope some of that made sense and didn’t offend - upset / bore anyone. I really don’t want people being put off / I want people to know the truth.

Thank you for writing this, it’s funny - I couldn’t have told you that this is how it works, but having read your post, it’s all come flooding back, especially how kind and caring the donation nurses were. I’m assuming it’s a fairly common scenario, as this is exactly how we lost my dad.

 

[Gembo]

I don’t know if it’s always the case, but we were with my dad right into the anaesthetic room before he went into surgery when they turned the machines keeping him alive off. We were with him at the end.

Thank you for writing this, it’s funny - I couldn’t have told you that this is how it works, but having read your post, it’s all come flooding back, especially how kind and caring the donation nurses were. I’m assuming it’s a fairly common scenario, as this is exactly how we lost my dad.

I’m really sorry for your loss. It sounds like your dad will have been treated with a great amount of care and respect and I hope his organs have gone on to help others. I’m glad the nurses were kind to you xx

 

[Itsallaboutmememe]

Years ago I found my dads card in his wallet and asked what it was for
he told me-adding ‘I’d rather someone else had use,rather than just rotting away’
the minute I was old enough I got a card myself/signed up online/told my family to use what ever they could
my daughter asked me years later and I told her what her grandad had told me so she signed up and I’m proud to say all mine have too,one by one
id be happy to take an organ if I had to so I have to be happy to give too

only thing that scares me is giving blood-I’m scared of needles and blood

i could swallow it back over the needle but it’s seeing the blood that puts me right off

im told I can ask not to see it tho so am going to look into it

 

[super grateful]

That sounds harrowing but thank you for explaining. I pray to god I’m never in that situation with someone I love. Can I ask, at what point does the patient die? Is it straight after theatre? Does he die alone, can his family be with him?

So there are two types of donation. Donation after brain death, or after cardiac death.

If the patient is declared brain dead then they are already dead, however we keep them artificially alive with a breathing machine/medication so that the organs that have been approved for donation will be in the best possible condition for the recipient. The family are made aware of this when they consent to donation. The family (if they want to) stay with the patient right up until we are ready to take him to the operating theatre.

If the patient has a really nasty injury/prognosis/is very unstable and unlikely to recover to any “meaningful state” (medically and qualify of life-wise, yet is not brain dead then they need to donate as a cardiac death donor. It sounds awful to say and I again I hope I don’t upset anyone here, but given all of the above, the plan will inevitably be to withdraw life sustaining treatment and allow the patient to pass away. Family have agreed to donation so in a case like this, death has to happen within 3 hours of the patient being taken off the breathing machine (any longer then the organs are not usable, as more than 3 hours without adequate oxygen etc is obviously not ideal). Often they do pass within this time frame because anyone who during the testing phase is felt to take longer to pass away will not be accepted by the donation team. Again family are made aware of all of this. They are with the patient until they pass (if they want to be) and then the patient is taken to the operating theatre.

After a patient has donated, I as the Nurse will wash them and do their hair etc, then the family can come back and say goodbye again if they wish. However most say their goodbyes before the patient goes to theatre and then decide not to visit again until the patient is in the mortuary.

I hope that made sense xx

Thank you for writing such a thorough account of what happens. I was in a very unfortunate position of battling sepsis a couple of years ago; it was touch and go and after a month in ICU (three weeks on a ventilator/trach) I survived.

As I’m sure you’re aware, when you’re in a medically induced coma you do hear all sorts of conversations, some false, others true. I’m hoping you can help me with one particular memory though. I remember quite clearly some doctors discussing the severity of my sepsis and that if I were to die, they couldn’t use my organs. Is this true or was it just delirium?

Oh gosh, I am sorry to hear that. I’m so glad you’re okay(?) now and able to talk about it!

Ouch, that’s a horrible thing to hear. I am sorry that has stuck with you. Like you say, fact and fiction often get mixed up but that’s really hard to call, it sounds quite specific!

Also I have seen patients with sepsis able to donate, and others not. Everyone is different. I’m upset that if those discussions were being had though that they were had around/over you!

I have no real answer I’m afraid. Just hope you can eventually stop hearing it xx

Thank you for writing this, it’s funny - I couldn’t have told you that this is how it works, but having read your post, it’s all come flooding back, especially how kind and caring the donation nurses were. I’m assuming it’s a fairly common scenario, as this is exactly how we lost my dad.

I am really sorry you had to go through that. I hope the fact your dad did something amazing brings you great comfort xx

 

[Piff paff puff]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

 

[Very traditional]

I'm the same with blood only I can't even bear
to have my blood pressure taken or think about blood, I get all panicked and faint. I feel so guilty for this as I would love to be able
To give blood.

Like many on this thread I had an organ donation card in my teens before the internet existed and Before I was old enough to legally be registered but I felt (and still feel) so strongly about how important it is.

Years ago I found my dads card in his wallet and asked what it was for
he told me-adding ‘I’d rather someone else had use,rather than just rotting away’
the minute I was old enough I got a card myself/signed up online/told my family to use what ever they could
my daughter asked me years later and I told her what her grandad had told me so she signed up and I’m proud to say all mine have too,one by one
id be happy to take an organ if I had to so I have to be happy to give too

only thing that scares me is giving blood-I’m scared of needles and blood

i could swallow it back over the needle but it’s seeing the blood that puts me right off

im told I can ask not to see it tho so am going to look into it

 

[50sGirl]

When I was 17 I became unwell,went to my GP who said I had flu ,I collapsed at home , went to hospital , hot given 12hours to live as it was kidney failure ,I obvs pulled thru and started dialysis , I gotta transplant 6months later (a 3yr old died ) fast forward 10years, and I became pregnant after being told I wouldn't /couldn't conceive . My daughter was born at 30weeks. Weighing 2lb. She was in hospital 6weeks,the day before she was allowed home my transplant failed. Iv been on dialysis 6.5 years ,but struggling to get a transplant as iv had a previous transplant,had a c section and had a baby, and blood transfusions ,which has caused me to have lots of anti bodies that would reject my new kidney. I hate dialysis so much. Traumatic but keeps me Alive. Has any body been through similar.sorry for long post .xx

My dad has been a dialysis patient for many years.
He says loads at the hospital moan about dialysis but, the way he deals with it is to accept that he has to dialyse for 3 days each week in order to live the other 4. I think that’s such a positive way to look at it.

You are much, much younger than him so it must be very hard for you, especially in the current climate. Are you having to shield?

 

[hrh89]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

this is a strange view to say the least...

 

[Bitofthebubbly]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

How many people needing organs are murderers? Not many I’d imagine.

 

[Piff paff puff]

How many people needing organs are murderers? Not many I’d imagine.

True but the thought of it ever happening changed my mind

this is a strange view to say the least...

Strange that you don't want your organs that you are giving voluntarily to go someone that could have killed someone, a child even? Strange that you think that's strange

 

[hrh89]

True but the thought of it ever happening changed my mind


Strange that you don't want your organs that you are giving voluntarily to go someone that could have killed someone, a child even? Strange that you think that's strange

but the chances are so slim! And you’d be dead so wouldnt know. And honestly yes it is a strange view. It’s not something that ever crossed my mind or many others I would of thought. When I agree to donate organs I just think about the life I could save and hope it goes to someone who needs it. I think it’s a very pessimistic way of looking at it when the first thing you think of is if it goes to the “wrong person”. Sorry its weird

 

[Chuck1978]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

The organ donation people wouldn’t know someone is a killer unless they’d been convicted and in which case they’d be in prison. In any case doctors treat convicted murderers every day for cancer, heart disease, Alzheimer’s and any number of other medical issues so they still have the obligation of “Do no harm” under their oath. Again the chances of this are so slim that you’re denying the majority of decent people the chance at a new life because of the less than 1% chance it could go to a murderer/rapist whatever. The needs of the many should outweigh the needs of the few in my opinion and if you’ve seen the difference transplantation can make up close and personal then it’s a risk 100% worth taking. Maybe you have other reasons for changing your mind though.

 

[Piff paff puff]

The organ donation people wouldn’t know someone is a killer unless they’d been convicted and in which case they’d be in prison. In any case doctors treat convicted murderers every day for cancer, heart disease, Alzheimer’s and any number of other medical issues so they still have the obligation of “Do no harm” under their oath. Again the chances of this are so slim that you’re denying the majority of decent people the chance at a new life because of the less than 1% chance it could go to a murderer/rapist whatever. The needs of the many should outweigh the needs of the few in my opinion and if you’ve seen the difference transplantation can make up close and personal then it’s a risk 100% worth taking. Maybe you have other reasons for changing your mind though.

I know the chances are small hence why I haven't made any effort yet to reverse my decision and of course I want to help someone in need but just not a criminal who has intentionally hurt an innocent person and I wish the law was such that they didn't receive donated organs.

 

[jazyblu]

True but the thought of it ever happening changed my mind


Strange that you don't want your organs that you are giving voluntarily to go someone that could have killed someone, a child even? Strange that you think that's strange

Strange that you would refuse someone a life saving organ, possibly a child to yours your own example, on the 0.00005% chance that the person had been a murderer.

 

[101d]

I opted in many moons ago now. Also registered to donate bone marrow if ever needed.

Aren't they making organ donation mandatory now?

 

[JoeBloggs]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

I think the likelihood of that happening is very small, you'd rather not give any organ for the small chance it may go to someone who has killed. Not to sound harsh, but you are dead anyway when they take your organs why would it matter who they go to. I suspect about 99% of the time they go to a 'non killer'. To me that is very sad that you would rather not save someone just incase in the very tiny chance it might go to a murderer. What if a child needed your heart? Out of curiosity, do you donate blood and if you needed an organ, would you take it despite not being prepared to give yourself?

I opted in as soon as I could, very glad its opt out only now.

 

[Giggling Squid]

this is a strange view to say the least...

It really is, the chances of it happening are negligible, especially given what the poster who works as an organ donation nurse said about it not always being the person most in need but the most practical, or something to that effect. I would imagine the logistics of donating to a murderer are so so slim, it to me doesn’t even seem worth thinking about.

it hadn’t even crossed my mind that this could be a thing, I often think about the people that received my dads organs, and wonder how they’re doing - it’s comforting that another family has hopefully been given more time with their family member.

 

[mcfeez]

I signed up years ago but have since changed my mind but don't know how to opt out. I changed my mind when I heard that anyone can receive donated organs such as killers

This is an odd train of thought. Where does the line get drawn in terms of who "deserves" an organ?

Your decision would also mean lots of regular good people, the more likely recipients, are being denied the chance to receive healthy organs.

 

[Channy86]

My dad has been a dialysis patient for many years.
He says loads at the hospital moan about dialysis but, the way he deals with it is to accept that he has to dialyse for 3 days each week in order to live the other 4. I think that’s such a positive way to look at it.

You are much, much younger than him so it must be very hard for you, especially in the current climate. Are you having to shield?

Yes I have to shield, hard though as I have a 6yr old, who mixes with her class, the teachers say she should be at school as guidelines state.xx

 

[spacebake]

I was fortunate enough to be part of the organ retrieval process at work I still feel very privileged to have been part of the patients final journey and it was a beautiful death , because this patient gave the gift of life from it. I still remember that persons name . I’ve been on the donation list since I passed my driving test but seeing it first hand , the care of our team doing the retrieval and the incredible benefit from it really cemented my belief that it’s the right decision

I do however also think it’s ok for people to not want to donate - I think people don’t like to be faced with their own mortality and the inevitability of their death? I think the more discussion , awareness and normalising of it could potentially change this mindset though , more support and conversation of the process should be in place maybe ?