Two separate sets of brain death assessments are carried out by two doctors to confirm that the patient's brain has died. The time when the second brain death assessment has been completed is the time of death of the person. This is the time of death that will be recorded on the death certificate.

Some time after the family has been told that their loved one has died (brain death), the intensive care doctor will discuss donation with the family. After the family has been given information about donation and what is involved they will make a decision about donation. If the family agrees to donation, a written consent form will be obtained for the organs and tissues they are comfortable with donating.

Following a family's agreement to donation, the donor co-ordinator for Organ Donation New Zealand is contacted. The donor co-ordinator obtains the medical information about the patient who is donating, liaises with the transplant teams and organizes the organ retrieval operation.

The transplant surgical teams travel to the hospital where the patient is being cared for. The patient is transferred to the operating rooms while the ventilator continues to supply oxygen to the organs until they are surgically removed. The operation is carried out as it would be for any other surgical operation, including the suturing and dressing of the incision(s) at the end of the operation.

The family may spend time with their loved one, if they wish, following the donation. Organ and tissue donation will not interfere with the funeral arrangements, including an open coffin, or having their loved one at home.

The health professionals involved in the donation operation ensure that the patient is treated with care and respect at all times.

The donor co-ordinator provides information and support to the family of the donor and will often meet the family prior to the donation. The family receives a letter of thanks that includes general information about the recipients - for example - 'the heart was transplanted to a man in his forties and the liver recipient is a woman in her twenties'.

The family also receives a booklet providing information about brain death, organ donation, transplantation and the grief process. Communication is continued for many months or years for some families.

Donor families can contact the donor co-ordinator at any time to find out the progress of the recipients. For some families, this is not something they choose to do, but for others it is important and they request this information for many years after the death of their loved one.

Although confidentiality is maintained, recipients are able to write an anonymous letter of thanks to the donor family. These letters are forwarded through Organ Donation New Zealand to the family of the donor, if they wish to receive them. Donor families are also able to write to recipients and these letters are handled in the same way.

The follow-up for donor families has increased over the years. We are aware that there will be families who generously donated in the past but received little or no acknowledgement or information. If you would like to receive information and support now or at any time in the future, please contact us.

Each year in April or May, a service is held in Auckland in recognition of those who have donated organs and given the gift of life to others. A second service is also held on alternate years in Wellington and Christchurch.

Donor families, recipients and their families, and health professionals are invited to these services.