Questions about donation

1. How brain death occurs
2. How doctors confirm brain death
3. Are there any cases where a patient was said to be brain dead and then recovered?
4. Will the doctors try hard to save me if they know that I want to be an organ donor?
5. What is the time of death for someone who is brain dead?
6. Can people who wear glasses donate their eyes for corneal transplantation?
7. What will the person look like after donation?
8. If you donate organs will funeral arrangements be delayed?
9. Can I be a donor if I have lived in the UK?
10. Can you donate an organ while you are still alive?
11. Am I too old to donate?
12. Where do I register to be an organ donor?
13. I do not have a driver licence, can I still donate?
14. Should I include my wishes in my Will?
15. Can my family over-rule my wishes?
16. Can I be a donor if I have an existing medical condition?
17. Can someone with cancer donate organs or tissue?
18. What is Donation after Cardiac Death?
19. What is the view of religious groups towards organ/tissue donation?
20. Can organs be sold in New Zealand?
21. I want to donate my body to medical science.

How brain death occurs
Most people understand that death occurs when a person's heart and breathing stop, but death also occurs when the brain dies. This is known as brain death.

After a severe head injury or brain haemorrhage (bleeding inside the brain), the brain becomes swollen in the same way that muscles become swollen when injured. As the brain is contained within the skull, which is rigid, the brain cannot expand to make room for the swelling. The pressure of the swollen brain will keep increasing to the point that it cuts off the blood and oxygen supply to the brain. When brain cells die they can never recover and this is brain death.

How doctors confirm brain death
Critically ill people are closely observed and monitored by the intensive care doctors and nurses caring for them. There are a number of physical changes in pupil reaction, heart rate, blood pressure and body temperature that happen when the brain dies. These changes together with the loss of other natural responses such as breathing, coughing and blinking cause doctors to suspect that the brain has died. Two separate clinical assessments are carried out by two appropriately qualified doctors to find out whether or not the brain has died. The time that the second brain death assessment is completed is the time of the death of the person.

Are there any cases where a patient was said to be brain dead and then recovered?
No. If you hear about people who were reported to have been brain dead and subsequently recovered, the term was not used accurately and these people were not actually brain dead. It is most likely that they had been in a deep coma with some brain function and blood flow to the brain and may have been able to breathe when the mechanical ventilator was removed. The crucial difference between brain death and coma is confirmed by the strict clinical assessments that must be carried out to determine if the brain has died.

Will the doctors try hard to save me if they know that I want to be an organ donor?
As with any patient, doctors and nurses will fight to save your life to the best of their ability. Only after there is absolutely no chance that you will recover, will organ donation be considered.

What is the time of death for someone who is brain dead - when the patient is declared brain dead, or when the heart actually stops beating?
The recorded time of death is when the two doctors have completed the second clinical assessment that confirms the diagnosis of brain death.

Can people who wear glasses donate their eyes for corneal transplantation?
In most cases those who wear glasses or contact lenses can donate eyes for
corneal transplantation.

What will the person look like after donation?
Organ donation involves a surgical operation carried out by highly skilled surgical teams. The incision(s) is carefully sutured and covered with a dressing, just the same as for any other surgical operation. After eye donation, the eyelids are closed over plastic shields to maintain the shape of the eyelids. Donation does not interfere with having an open coffin and does not prevent the family from having their loved one at home.

If you donate organs will funeral arrangements be delayed?
Funeral arrangements are not affected by donation. Organ donation happens within a few hours after death and there is no reason to delay arrangements.

Can I be a donor if I have lived in the UK?
Yes, in most cases. People who have lived or visited the UK can donate, including kidney, liver, heart, lung, pancreas and eyes.

However, the donation of heart valves, skin and blood is not permitted if a person has visited or lived in the United Kingdom (England, Scotland, Isle of Man and the Channel Islands), Republic of Ireland (Eire) or France between 1st January 1980 and 31 December 1996 for total period of more than 6 months. This is due to the risk of transmission of Creutzfeld Jacob Disease (CJD) which is more commonly known as Mad Cow Disease.

Can you donate an organ while you are still alive?
Yes, in some cases.

The most common organ donated by a living person is a kidney. A healthy person can lead a normal life with only one kidney. Approximately half of all kidneys transplanted in New Zealand are from living donors. Similarly, a segment of a liver can also be donated from a healthy adult and transplanted to a child or an adult. Before living donation can take place the person donating his or her organ will undergo a very thorough medical and psychological assessment.

If you would like to find out more about living donation contact you nearest kidney transplant centre (Auckland, Wellington or Christchurch) or the New Zealand Liver Transplant Unit.

Am I too old to donate?
People of all ages can be considered for liver and kidney donation. Eyes can be donated up to the age of 85 years, skin up to 80 years of age, heart and lungs up to 65 years, heart valves up to 60 years and pancreas up to 45 years of age.

Where do I register to be an organ donor?
You can register your wish to donate when you apply for a driver licence, or when you renew your licence every ten years. If you indicate your wish to donate the word 'donor' will be printed on your licence. The most important step, however, is to talk to your family and let them know your wishes.

Designated health professionals can access the Land Transport New Zealand donor information for the family if donation is being considered and the family does not know the wishes of their family member.

I do not have a driver licence, can I still donate?
While you can register your wishes on your driver licence, the most important step is to ensure your family or friends are aware of your wishes. At the time when donation is being considered your family or friends will always be asked if they know your wishes. If you have told your family or friends, there is nothing else you need to do.

Should I include my wishes in my Will?
By the time a will is read, most commonly, it will be too late for donation to be considered. The most important step is to ensure your family and next-of-kin are aware of your wishes to donate.

Can my family over-rule my wishes?
Your family will always be asked if they are aware of your wishes to donate. If the family is aware of the wishes of their loved one, this can sometimes make the decision a little easier. Most commonly families do respect the wishes of their family member.

Can I be a donor if I have an existing medical condition?
Yes, in most cases. Having a medical condition does not necessarily prevent a person from donating organs or tissues. At the time when donation is being considered, health professionals will take into account a person's past medical history and a decision will be made about whether some or all organs and tissues can be donated.

Can someone with cancer donate organs or tissue?
Cancer may not always prevent you from donating. This decision will be made by the medical staff when donation is being considered and will be dependent on the type of cancer, the type of treatment and the length of time since the treatment. While some cancers might prevent organ donation, eye donation is often possible. For more information please contact us

What is Donation after Cardiac Death?
Donation after cardiac death (DCD or 'Non Heart Beating Donation') allows the option of organ donation in patients who have a non-survivable head injury but do not fulfill brain-death criteria and are therefore not brain dead.

When a patient has a non-survivable head injury a decision to withdraw treatment is made by the medical team and the family. Some time after this decision has been made organ donation would be discussed with the family. If the family is in agreement with donation, treatment would be withdrawn and care would be continued until the patient had died. Organ donation would commence shortly after the death of the patient.

However, it is important to understand that the decision to withdraw treatment is made entirely independently and prior to any discussion about donation.

What is the view of religious groups towards organ/tissue donation?
Most religious groups support the concept on the basis that organ/tissue donation is a gift of life to another individual. If you are in doubt, however, consult your minister or elder.

Can organs be sold in New Zealand?
No. This is considered unethical and New Zealand transplant surgeons maintain a strict code of conduct that does not condone this practice.

I want to donate my body to medical science.
A decision to donate your body to medical science generally means that organ donation is not an option. For more information about donation for medical science contact:

Department of Anatomy
Auckland School of Medicine
Private Bag 92019
Auckland
Phone: 09 373 7599 ext 6703

Department of Anatomy and Structural Biology
Otago Medical School
P O Box 913
Dunedin
Phone: 0800 580500

Organ Donation New Zealand

Questions about donation