How organ donation works

Organs that can be donated in Ireland are:

• Heart
• Lungs
• Liver
• Pancreas
• Kidneys

Who can be considered a potential organ donor?

A potential donor has to be in a hospital and maintained on a life support machine (ventilator) before they can become an organ donor. A person’s organs can be donated after:

• Brain stem death
• Cardiac death

Brain stem death means that there is no blood flow or oxygen to the brain. The brain is no longer functioning. There is no hope of recovery. The patient cannot breathe without the help of the ventilator. Doctors will carry out tests to confirm brain stem death. Two sets of tests are carried out. The time of death recorded on the death certificate is when the second set of brain stem tests have been completed.

Donations after Brain stem Death (DBD)

Organ donation can be considered when a patient on a life support machine is diagnosed brain stem dead. This could be as a result of a massive brain haemorrhage or some form of head trauma. Brain stem death is the permanent loss of function of the brain stem and this is ascertained through tests carried out by two senior doctors to determine absence of brain function. When these tests show that there is no brain function and no chance of recovery, the patient is declared dead.

At this stage, the family may wish to discuss the option of organ donation or may be approached by the medical or nursing staff in the Intensive Care Unit to discuss the possibility of organ donation. The ventilator or life support machine will keep the blood circulating after death, which means the organs can be maintained for transplantation. The medical staff provide information and support to the family in making their decision.

Cardiac death happens after an illness or injury from which a patient cannot recover. The patient is not brain dead, but has no hope of recovery. The patient cannot survive without the support of a ventilator and medication.

If you decide to consent to organ donation on behalf of a loved one, we need to ask you questions about the health and lifestyle of your deceased loved one. You may find some of these questions sensitive but they are necessary so that the transplantation process can proceed.

Written consent is required from you, the next of kin, at the time of donation. Only organs that you give consent for can be donated and used for transplantation. We take blood tests, including one for viruses, to ensure that organs are suitable for donation. We will inform you if there are any health implications as a result of this testing.

Donation after circulatory death (DCD) occurs when a patient donates organs following the determination of death by cardio-respiratory criteria. A strict protocol is followed before this is considered. The medical team or the donor coordinators can provide more information.

All religions support organ donation. If you have any concerns please speak to hospital staff.

Organ donation only takes place after your loved one has died. The operation is carried out by highly skilled doctors and nurses in the operating theatre in this hospital. The dignity and respect of your loved one is a priority at all times.

After the donation operation, your loved one looks the same. The donation process will not delay funeral arrangements. The donor coordinator will write to the donor family after a few weeks giving an update of each person who benefitted from the organ donation. The identity of your loved one and the person who received the donated organs are at all times kept confidential.

Organ donors save hundreds of people’s lives each year.

A recent survey has shown that more than 80% of the Irish population agree with organ donation.

Thank you for considering the gift of life.

Once the decision to proceed with organ donation has been made by the family, the donor coordinator from the National ODTI  Service in Dublin is contacted.

In 2015 Organ Donation and Transplant Ireland (ODTI) was set up to comply with EU regulations as the national service. This is a 24/7 service provided  365 days a year.

Donor coordinators organise the donation process providing support and advice to all families and hospitals nationwide. The coordinators  contact the transplant centres who find suitably matched recipients and schedule a time for the donation to take place.

The donor coordinator then travels to the local hospital and meets the donor family. The donation process is described and outlined and any questions the family may have are answered.

As part of the process a detailed health and lifestyle questionnaire is completed with families to ensure there are no contraindications to donation. Having spoken with the donor coordinator if the family then wish to proceed with organ donation, the family will then be asked for consent. Only organs which are specifically consented for are taken for transplantation and only if a suitable recipient has been identified.

There are also six Specialist Organ Donation Personnel available locally, within the hospital groups around the country who assist with the organ donation referral and support families making end of life decisions regarding organ donation. Additionally, they provide education and training for local hospital staff.

Transplant teams - caring for a vulnerable community

The donor operation takes place in the operating theatre by the transplant teams in the hospital where the donor has died, under the same surgical conditions as any other operation.

There are individual transplant teams for each of the organs that are being donated, and the surgery is performed by specialist transplant teams from the individual transplant centres: the Mater Hospital for heart & lung, St Vincent’s Hospital for liver and Pancreas and Beaumont Hospital for kidney.

Each team consists of two surgeons and a nurse. The donor coordinator is present in theatre during the surgery to support both the donor and transplant personnel during the process, and cares for the donor after the procedure. It is the highest priority of our teams to maintain dignity and respect for the deceased person at all times.

Recipient operation

Following donation, each individual team takes responsibility to transport the organ back with them to the transplant centre where the recipient operation will take place. The transplants are carried out without delay as soon as the recipients are prepared for the operation.

The Gift of Life

4-6 weeks following the donation, the ODTI donor coordinators will write to the donor family thanking them and giving them news of each recipient who has benefited from the donation. At any stage following donation, a donor family may contact the donor coordinator to enquire about the well-being of the recipients.

The gift of life is the greatest gift to receive. Each year in Ireland approximately 300 transplants take place, each offering new life to so many. This new life is given through the thoughtfulness and unselfishness of so many donor families who make that very brave decision to donate their loved ones’ organs for transplantation. Transplant recipients are forever grateful and remember their donor and donor family every day of their new lives.

The National Living Donor Renal Transplant programme is run by the National Renal Transplant programme at  Beaumont hospital. Click here for more information, or contact the Renal Transplant Co-ordinator, Beaumont Hospital, at (01) 809 2759 or (01) 809 2298.

The Living Donor Reimbursement Scheme

The reimbursement scheme allows for living donors to claim some loss of earnings and out of pocket expenses directly due to the living donation, up to a maximum limit set in the policy.  More information can be obtained from the Transplant Coordinator, Beaumont Hospital, at (01) 809 2759 or (01) 809 2298.