With the repercussion of Gugu’s death, I had doubts about how an organ donation procedure occurs. How he does to have his organs donated (after his death) or how to proceed when a relative dies. How does organ donation work in Brazil?
1 – Diagnosis of brain death
At first, anyone who has had brain death confirmed may become a donor. This is an irreversible condition in which the total cessation of brain function is diagnosed. Tests such as electroencephalogram and brain angiography are performed to certify the doctors and the family of the organ arrest.
In general, this occurs after head trauma or vascular accidents. However, despite the brain failure, the heart continues to beat and it is the blood supply that keeps the organs viable for donation. The circulation is maintained artificially, by means of devices and medication, while the Transplant Center is notified and the family is notified of the situation.
2 – Family authorization
After the diagnosis of brain death, the family should be consulted and oriented on the process of organ donation. After six hours of certifying brain failure, the potential donor undergoes a new clinical test to confirm the diagnosis. The family is then asked about the desire to donate the organs.
Written messages left by the donor are not valid to authorize the donation. Therefore, only family members can give their consent to the surgery, after signing a term. According to the Ministry of Health, half of the families interviewed do not allow the removal of the organs for donation.
Therefore, it is important to talk to the family still alive to make this wish clear.
3 – Family interview
After the brain death is confirmed and the family’s desire to donate the relative’s organs is expressed, the medical team carries out a questionnaire with the relatives to detail the patient’s clinical history. The idea is to investigate whether the donor’s habits would have led to the development of possible diseases or infections that could be transmitted to the recipient.
Chronic diseases such as diabetes, infections or even injecting drug use can end up compromising the organ that would be donated, making transplantation unfeasible. Therefore, the medical team checks the donor’s clinical history. The interview is a guide for doctors, who still perform biological and physical tests that also indicate possible compatibility with the recipients in the transplant queue.
4 – Organ removal
From the same donor, it is possible to remove several organs for transplantation. In general, the most recurrent surgeries are those of the heart, lungs, liver, pancreas, intestine, kidneys, cornea, vessels, skin, bones and tendons. With this, countless people can benefit from the organs of the same donor. Organs that last less time once out of the body are removed first.
In the 27 integrated notification centers, the computerized data of the donor are crossed with those of the people waiting in line for the organ so that the ideal candidate, according to urgency and waiting time, can be found anywhere in the country.
The professionals involved in the process work in countdown so as not to exceed the time limit for the removal of the organs and also for their preservation during transportation.
5 – Transportation
When the donation is between people from different states, the Ministry of Health makes air transportation of tissues and organs possible. The portfolio has a voluntary cooperation agreement with airlines to ensure the transfer. The companies transport the organs free of charge on commercial flights.
In 2015, the Ministry of Health made it possible to transport 1,164 organs and 2,409 tissues for transplants by means of a cooperation agreement, as well as 110 organs and 219 tissues by means of chartered flights and ground transportation in partnership with the State Transplant Centers.
To reinforce the transportation process, the acting president, Michel Temer, by means of a decree, determined that the Brazilian Air Force (FAB) also provide support to the Ministry of Health, especially in missions requested by the National Transplant Center.
6 – Recovery
After transplantation, the patient has a postoperative similar to other surgeries. But the success of the operation depends on several factors, such as the organ conditions and the patient’s health status. However, he will have to take immunosuppressive medications throughout his life to avoid a possible rejection of the body to the new organ.
The Ministry of Health’s estimate is that the survival of patients after five years of surgery is 60% in cases of liver and lung transplants; 70% for heart replacement surgeries; and 80% for kidney transplants.