Organ Donation

Question 1

What is cardiac death?

Answer 1

The irreversible cessation of circulation of blood in the body of the person

Question 2

What is brain death?

Answer 2

The irreversible cessation of all function of the brain of the person

Question 3

What are common causes of brain death?

Answer 3

Trauma
road trauma
hypoxia
cerebral vascular accidents

Question 4

If organ donation was to occur what needs to happen upon death?

Answer 4

• Two doctors
- one a specialist
- must confirm brain death
• Neither may be involved with the removal or transplantation of organs
• Certification of death is at completion of the 2nd brain death test. This is the legal time of death

Question 5

What is done in the brain test?

Answer 5

Pupils fixed in diameter and unresponsive to incident light
Absent corneal reflex
Absent vestibulo-ocular reflex
Absent motor response/limb movement
Absent gag reflex or cough reflex response to bronchial stimulation
No respiratory movement when disconnected from the ventilator

Question 6

What happens in cerebral angioplasty

Answer 6

done if brain death can’t be determined by brain test

blood flow will cease at Right Internal Cerebral Artery

Question 7

What assessment needs to happen for the organ after removal?

Answer 7

• Observe for return of normal organ function
• Signs of rejection:
– An immune response against graft
• Hyperacute: within minutes
– rapid, widespread vascular thrombosis
– severe graft necrosis and organ failure

Question 8

Once the organ is in the new host what assessment needs to be done?

Answer 8

• Acute rejection – hours to days
– Pain, tenderness, over graft site, decreasing graft function, fever, malaise
– Treat with immunosuppressant drugs
• Chronic rejection
– months to years after transplant
– gradual loss of graft function
– signs unique to organ transplanted – Graft versus host disease (GvHD)

Question 9

What are some nursing problems following transplantation?

Answer 9

High risk for infection due to altered immune response secondary to anti-rejection medication
– Health professionals wash hands
– Protect from environmental risks
– Maintain meticulous hygiene
– Cautious use and care of IV lines and sites – Avoid invasive procedures
– Ongoing monitoring for fever
– Administer antibiotics as prescribed

Question 10

What education does the pt need to receive about having low immune system

Answer 10

• Initially:
– Avoid large crowds
– Avoid pets or keep pet and environment clean 
• Continuing:
– Report signs of infection
– Avoid gardening, liveplants
– Avoid aspirin or ibuprofen (bleeding) 
– Drug specific information