Deciding to become an organ donor is a very good thing to do.
There is a huge shortage of organs available for transplant and close to 100,000 patients are on a waiting list to receive them.
I can only encourage you to consider becoming an organ donor.
I often see patients in the Intensive Care Unit with severe and irreversible brain damage.
Most of those patients could have become organ donors.
Many patients had even expressed their desire to become an organ donor prior to becoming disabled.
Few of them actually donate their organs.
Why is this happening? Often, it becomes a family decision to proceed with organ donation.
The lack of understanding of the basic procedures involved in organ donation and organ harvesting can lead the family to decline it.
I have seen, on a multiple occasions, family changing their minds in the last moment.
Patients become organ donors in two cases: if the patient is pronounced brain dead or if the patient is suffering from a severe and irreversible condition with no meaningful chance for recovery (usually severe brain damage from trauma, bleed or stroke).
In both cases, the patient should be considered a suitable donor based on the overall picture of health.
If the patient is pronounced brain dead based on clinical criteria and a confirmatory test, his or her organs could be taken immediately.
It takes some time, though, to run all the necessary tests on the organ donor.
Matching the donor with the organ recipients will likely delay this process as well.
And, finally, depending on the location of the hospital, allow some time for the transplant team to get in there.
All in all, it might take 8 to 18 hours before the organs could be harvested.
This is considered to be a more "straightforward" process.
If the patient is not brain dead, the process could take even longer.
At this point the donation is possible per the DONATION AFTER CARDIAC DEATH (DCD) PROTOCOL.
In this case, the donor becomes a non-heart beating donor.
What it means is that the patient will be taken to the operating room where life support is going to be removed.
If the patient is pronounced dead (no spontaneous breathing or heart beat) within a short period of time (usually 2 hours) his or her organs will be taken for donation.
Often, it takes some time for the patient to become "ready".
It is not unusual to wait up to several days for the neurological damage to progress so that there is a higher chance of the patient dying within two hours so that the organs could be taken.
It is often hard for the family to wait up to several days after they decided to withdraw care.
In my experience, the need to wait and the uncertainty of the process often make the family change their mind.
The physician overseeing the process of organ donation is allowed to administer pain medications to keep the patient comfortable.
The line between keeping somebody comfortable and facilitating death is somewhat blurry, though.
A transplant surgeon from California was charged with accelerating the death of a patient to harvest his organs by administering high doses of Morphine.
The physician was later acquitted of felony charges.
In conclusion, the process of organ harvesting is a very involved and even lengthy process.
A better understanding on the part of the family might improve our chances of providing more organs for the patients in need.