Department of Computer Science Stony Brook University Lecture 4: Deceased vs. Living Donors Scott A. Smolka Department of Computer Science Stony Brook University http://www.cs.sunysb.edu/~sas/

Deceased Donors & Brain Death Bodies of those who have suffered brain death can be maintained on a ventilator, which provides oxygen to the heart to keep it beating. Such people can donate following organs and profoundly help many people, both saving and improving lives. Heart Lungs Liver Kidneys Pancreas Small Intestine Corneas/Eyes Heart Valves Skin Bone Veins Individuals organs are removed in operating room while heart function is maintain with artificial support.

Deceased Donors & Cardiac Death Those who have suffered cardiac death have no cardiac or respiratory function Because of this, many organs in body already damaged Patients who suffer cardiac death can still provide following donations: Corneas/Eyes Heart Valves Skin Bone Veins Tissue can be donated up to 24 hours after death.

Kidney Partial Liver Partial Lung Living Donors Living individuals who may or may not be related to the potential recipient(s). Potential living donors undergo screening and compatibility testing. Transplants possible from living donors include: Kidney Partial Liver Partial Lung Bone Marrow Blood

“Brain Death is Death” or What Does Brain Death Mean? Brain death means there is no blood flow or oxygen to brain Therefore the brain cannot function in any capacity and never will again Does not mean that other organs, such as heart, lungs, kidneys, pancreas and liver are dead, although they may only function for a few days Unless damaged by disease or injury, these organs may be used by another individual via organ transplant

How is Brain Death Determined? Two licensed, independent physicians perform a series of tests to determine whether or not brain death has occurred Death is indicated if the patient: cannot breathe without assistance has no pupilary response to light or other central nervous system reflexes has no response to pain

Why Does the Heart Continue to Beat? The heart has its own pacemaker, independent of the brain With oxygen, the heart will continue to beat

Brain Death and Respiratory Support Would removing respiratory support from a patient be the same as not giving him or her all possible chances for survival? Once patient is brain dead, he or she is dead because the brain will not recover Respiratory support equipment only keeps the heart beating, supplying the vital organs with oxygen Recorded time of death is when the patient is declared dead, not when the heart actually stops beating

Further Questions about Brain Death Does body of a brain-dead patient sometimes begin to deteriorate, even if patient is on life support? Failure of many organs begins soon after brain death Does the patient feel any pain during donation? No, the person is dead and no longer feels pain

Causes of Brain Death Trauma to the Brain Examples: severe head injury caused by motor-vehicle crash, a fall, or blow to the head Cerebrovascular Injury (massive bleeding or blood clot in brain) Examples: stroke, aneurysm Anoxia (loss of oxygen to the brain) Examples: drowning or heart attack (when emergency procedures result in restoration of heartbeat and respiration, but not before lack of blood flow / oxygen to brain has caused brain death) Brain Tumor Uncontrollable growth of a brain tumor can cause permanent loss of blood flow/oxygen to the brain

Brain Death vs. Cardiac Death Brain-dead patient is ventilated, meaning he or she is taking in oxygen via a machine Although that oxygen is not feeding brain, it may be feeding body’s vital organs, keeping organs viable, suitable for transplant Cardiac death means patient is without oxygen. His or her heart has stopped beating Person not able to donate organs, but may donate tissue

Brain Death vs. Cardiac Death (continued) Patient is maintained on a ventilator and the cardiac output is maintained.  Donor organs are removed in the operating room while organ function is maintained with a ventilator, fluid and medication. Patient has no cardiac or respiratory activity. Body must be kept cool if tissues are not removed immediately. Removal of most tissues occurs within 24 hours of death. Acceptable Donations heart or heart valves kidneys liver pancreas lungs small intestine (Tissue can be recovered following organ removal) heart valves bone ligaments tendons cartilage skin veins fascia middle ear corneas

5-K Course Project Proposal, co-authored by Margaret Gallagher of NYODN, submitted to Dean of Students Jerry Stein, Assistant VP George Meyer, and Director of Office for Conferences & Special Events Arlene Skala Date of event may change to avoid conflicts; run part may be eliminated to avoid road closings Let’s still plan on setting up shop in SAC lobby on two consecutive Tuesdays (during class time) in April

Things to Do this Week Visit http://www.optn.org and http://www.unos.org Enroll at least one person in the New York State Organ and Tissue Donor Registry Discuss organ and tissue donation with your family