Deceased organ donation for transplantation: Challenges and opportunities

Table 1 Brain stem reflexes

Corneal reflex

Cough reflex

Facial motor response to painful stimuli

Gag reflex

Oculocephalic reflex (“Doll’s eyes”)

Oculovestibular reflex (caloric response)

Pupillary response to light

Table 2 Definitions[14]

Donor	A person from whom at least one organ was procured for the purpose of transplant, regardless of whether the organ was transplanted
Eligible death	Death of a person aged 70 yr or younger, legally declared brain dead according to hospital policy and without exclusions listed in OPTN policy
Imminent neurological death	70 yr or younger, ventilated, with severe brain injury and without exclusion criteria, lacking 3 brain stem reflexes but not fulfilling BD criteria
Potential donor	Patient with devastating irreversible brain injury apparently medically suitable for organ donation and suspected to fulfill BD criteria

BD: Brain death; OPTN: Organ Procurement Transplantation Network.

Table 3 Criteria for referral of a potential donor

Every ventilated patient with

Glasgow coma scale of 5 or less without sedation

Brain death testing being considered/pursued

Do-not-resuscitate or comfort care being considered

Withdrawal of support being considered

Family initiates conversation about donation

Every cardiac death within 1 h