Two Ways to Be a Hero: Explaining Types of Organ Donation

Organ donation is a beautiful gift, but it is very rare. Only about 1% of people who die will be able to donate. Cody Mogensen was one of those heroes. When he was hospitalized after a drug overdose, his family was devastated. Paramedics and the hospital care team did everything they could. When his family learned he wasn’t going to recover, they made the decision to let Cody die naturally.

His mother, Lori, said the family wanted Cody to make a difference through organ donation. “We didn't think twice about donating. We had no problem with it. And it's what Cody would have wanted us to do. And I knew that because we had talked about it, he was such a giving person.” Cody donated his kidneys, liver, and lungs, saving 4 lives.

Cody donated through a process called Donation after Circulatory Death or DCD. This is one of the two different ways a person can become an organ donor. We’re here to break down this complicated topic and help you understand the two pathways to donation.

Two Different Pathways

It starts when a person is brought to the hospital with a life-threatening injury or illness. The hospital care team will make every effort to save the patient’s life. If the patient isn’t going to recover, the hospital team will talk to the family about their options. This conversation is only about the patient’s condition, and LifeShare is not involved in this discussion.

• BRAIN DEATH This is when a person has a serious illness or injury that causes permanent damage to their brain. Brain death is a term for what happens when the brain and brainstem stop working. Legally and medically, this is death. The hospital’s care team will conduct tests to confirm brain death.
• CIRCULATORY DEATH This is when a person has a serious illness or injury but is not brain dead. They will not make a meaningful recovery and will need machines to keep their body functioning. If the family feels the patient wouldn’t want to live this way, they can choose to let them die naturally. This is done by having the hospital care team remove the ventilator, which is a machine that is breathing for them. You may have heard this referred to as “removing life support” or “withdrawing care.” After the machines are removed, the person’s heart will eventually stop beating. That’s when the hospital care team declares the patient dead.

In both types of cases, all decisions up to this point have been made by the family and the hospital care team. Next, the family will have to make end-of-life decisions, which may include organ donation.

If the patient was a registered donor or the family decided to donate, the donation process will begin. After all medical history has been reviewed and organs have been matched with transplant recipients, it’s time for the organ recovery surgery. Depending on the type of death, the process will be different.

Donation After Brain Death

A brain-dead patient has been declared legally and medically deceased but remains on a ventilator. The family says their final goodbyes in the patient’s room. Then the LifeShare team takes the patient to the operating room (OR) for the organ recovery surgery. Before the recovery begins, our team pauses for a moment of honor to pay their respects to the donor.

Donation After Circulatory Death (DCD)

When a family decides to withdraw care, the process is the same whether donation is taking place or not. The only difference is where  it happens. If the patient is going to be a donor, the hospital care team will remove the ventilator in the hospital’s operating room instead of in the patient’s room.

After removing the ventilator, the hospital care team monitors the patient and gives them medicine to keep them comfortable. For organ donation to happen, the patient’s heart must stop beating naturally within 2 hours. When the heart stops, the hospital team will declare the patient deceased. After that, there is a 5-minute waiting period before the organ recovery surgery can begin.

If the patient doesn’t die naturally within 2 hours, organ donation does not happen. The patient is taken back to a room, where the hospital team will continue to support them and keep them comfortable until their heart stops beating.

This process is carefully planned and executed by the hospital care team and LifeShare. Our team is not involved in the patient’s care until after the hospital team has declared death.

Supporting Our Families

LifeShare recognizes the importance of being with loved ones at the end of life. That’s why we allow the family to be with the patient during this time. Our clinical teams prepare the patient and the OR for the organ recovery surgery. Then the hospital team removes the patient’s ventilator and steps out to give the family privacy.

The family can sit with and talk to their loved one, spending their final moments together. When the patient’s heart stops, the hospital team confirms with the family that the patient has died. LifeShare staff then escorts the family out of the room. Then, the 5-minute waiting period begins, and after that, the organ recovery surgery takes place

LifeShare supports the patient and the family throughout the process. If the family chooses not to go to the OR, a LifeShare family support coordinator will stand in for them. They will sit with the patient, comforting them and talking to them during their final moments.

Saving More Lives Through DCD

Until recently, brain death was the most common pathway for a person to donate their organs. But as medical technology has advanced, Donation after Circulatory Death has become more common. Because of this, we’ve been able to recover more organs and save more lives.

At LifeShare, we believe every person who wants to save lives through organ donation should be given the chance. Cody wanted that chance, and because of DCD he saved 4 lives. If it wasn't for DCD, heroes like Cody wouldn’t be able to donate and more people would be waiting for a lifesaving transplant.