Introduction

We can only imagine the pain that you’re feeing now. Every day we sit with families in their most dark and challenging moments. That grief is heavy and humbling. We are here to support you through the donation process, and to tell the stories of other families, to share how they may have struggled to find comfort and meaning in a time of deep loss.

Why is organ and tissue donation so important?

Organ and tissue donation is one of the greatest gifts that a person can give, and the opportunity to donate is extremely rare. Less than 1% of deaths even allow for the possibility of organ donation.

For the recipients of transplants, the gift of donation is nothing less than a miracle — an answered prayer and a second chance at life. Recipients are deeply grateful for the chance to honor the legacy of their generous donor.

For the families of donors, knowing that their loved one has left a lasting legacy of hope and healing often provides comfort and solace.

On average, more than 100,000 people in the United States are on the transplant waiting list, including nearly 2,000 of our Northwest neighbors. Approximately 20 people die each day while waiting for a transplant.

We want your family to know that the need is great — and that the opportunity to donate is extremely rare.

We’re here to support you during an extremely painful time. We’ve talked to many families about the end-of-life decisions that come with the sudden and tragic loss of a loved one. The answers that follow are the ones that have helped them the most.

Who is LifeCenter Northwest?

LifeCenter Northwest is a nonprofit federally-designated organ recovery organization with a single purpose: to save lives through organ and tissue donation.

We work with families, hospitals, and transplant centers across our region to make donation and transplantation possible. We seek to be good stewards of the gift of life — and to honor the courageous donors and families who make donation possible.

Questions About Death

There are two ways that people die: when their heart stops (cardiac/circulatory death) and when their brain dies (brain death). Both brain death and cardiac / circulatory death are formal, legal definitions of death.

What is “brain death”?
Brain death means that the entire brain — both the upper and lower parts — have stopped functioning, completely and irreversibly. Every cell in the brain has died. Brain death is death, and it is permanent.

Is “brain death” like a coma or a vegetative state?
Brain death is not a coma, and it is not a persistent vegetative state.

A coma is a prolonged state of deep unconsciousness. In a coma, the brain still has activity and function, and the person may still breathe when a ventilator is removed.

A patient in a coma might transition into a persistent vegetative state. In this state, they have lost all awareness and most cognitive functioning, but their lower brain stem is still healthy and functioning.

When brain death occurs, all functions of the entire brain have stopped permanently with no chance of recovery.

How does brain death happen?
Brain death occurs when the flow of blood to the brain is stopped for an extended period of time.

This is often caused by:

  • Extreme injury, such as head trauma from a fall or vehicle accident.
  • An aneurysm or stroke that leads to a ruptured blood vessel in the brain.
  • Cardiac arrest resulting in a lack of oxygen to the brain.

Whatever the cause of brain death, all brain function stops — even the most primitive, life-sustaining reflexes such as the ability to breathe.

How does a doctor know that brain death has occurred?

The American Academy of Neurology has agreed on an extremely rigorous set of tests to determine brain death. These tests are based on
worldwide standards and decades of research.

Tests for brain death are only conducted when there is no evidence of higher brain function and all other possibilities have been ruled out — including the presence of some drugs (such as sedatives) that can create the appearance of brain death.

For a declaration of brain death, there must be:

  • No brain stem or pupillary reflexes (although the spine may still cause reflexes, such as twitching).
  • No ability to breathe independently without a ventilator.

Your doctor can describe all the criteria used to determine brain death in more detail. No one who has met these strict criteria has ever recovered.

Why is my loved one’s heart still beating? Why do they appear to be breathing?
If a ventilator continues pumping oxygen into the lungs, the heart is capable of beating for a limited time even without communication from the brain. The skin may still have color and warmth, and movement of the extremities is possible, but these are not related to brain function. Without the artificial machine support of the ventilator, the body could not breathe on its own and the heart would stop.

What is cardiac/circulatory death? How is it different from brain death?
Cardiac/circulatory death is death that occurs because the heart has stopped beating completely.

Sometimes, an irreversible brain injury (or some other chronic condition) will be so serious that the patient cannot survive without support from a ventilator — but brain death has not yet occurred. In these situations, the family and care team may choose to withdraw ventilator support because there is no chance for improvement in their loved one’s condition.

Cardiac/circulatory death occurs naturally after ventilator support is withdrawn.

Questions About Donation

How are the organs removed?
Organ removal occurs in a similar manner to any major surgery, in an operating room with specially trained doctors and nurses. Your loved one is treated with the utmost dignity and respect during this process.

Is there any pain or suffering?
No. Organ removal happens only after the heart has stopped beating and death has been declared. A person who has died no longer has any sensations and can feel no pain.

Does my religion support organ donation?
Most major religions in the U.S. support organ and tissue donation as a humanitarian and selfless act of giving. To give of oneself in this way is the expression of a true, deep act of love for one’s neighbor. Leaders of many faiths believe that donation is a matter of individual decision and respect an individual’s right to make decisions regarding their own body.

Will we know what happens to our loved one’s gift?
You will receive a letter approximately four weeks after donation with general information about the recipients. You will have the opportunity to write to those recipients if you wish, and they may choose to write back. Your family and the recipients of your loved one’s gift can decide how much contact you wish, if any.

Will donation impact funeral arrangements?
There is usually no impact and donation still allows for the option of an open-casket funeral. Sometimes there can be a delay in funeral arrangements, but every situation is different. Talk to us about how we can help with any cultural considerations, end-of-life rituals, or funeral needs that are important to your family.

Is there any cost?
All costs associated with donation are paid by LifeCenter Northwest. Occasionally, families will receive a bill inappropriately. We will help you navigate the details if you receive a bill that should be directed to us. For more information, please call (425) 201-6563.

The Four Steps of Donation

Our staff will be here with your loved one throughout the donation process. The donation process is unique for every donor, based on individual circumstances and medical history — but we’ll be here the whole time, to support your family and answer any questions.

Step 1: Evaluation

At this step, our staff will work closely with your loved one’s nurses and doctors to make the most of this generous gift. This may be a good time for your family to pause and catch your breath.

LifeCenter Northwest/hospital staff will…

  • Ask your family questions about your loved one’s medical and social history.
  • Review medical history in your loved one’s chart.
  • Draw blood periodically to determine how organs are functioning.
  • Test blood results at a lab to determine the best matches for your loved one’s organs.

Your family might…

  • Ask questions.
  • Return home to rest, and we will call with any updates.
  • Contact family, so they can come to the hospital for goodbyes.
  • Spend additional time with your loved one.
  • Call someone for spiritual care to visit with your family.

Step 2: Monitoring

Our main goal throughout the donation process is making sure that your loved one’s gift helps and touches as many lives as possible. During this step, we will be closely monitoring and caring for your loved one, to improve their organ function before a match is found.

LifeCenter Northwest/hospital staff will…

  • Closely monitor organ function.
  • Possibly conduct additional tests, such as CT scans, angiograms, and blood draws.
  • Optimize organ function to ensure a successful transplant.

Your family might…

  • Work on “memory making” activities.
  • Identify a funeral home.
  • Return home to rest.
  • Ask questions.

Step 3: Matching

Finding a match for your loved one’s gift is a complex process, and the evaluation and matching steps may overlap. We start by generating a list of possible matches through a centralized national computer system. We then compare your loved one’s characteristics to those of potential recipients. Factors affecting the list of matches include the amount of time potential recipients have been waiting, how sick they are, and their proximity to the hospital.

LifeCenter Northwest/hospital staff will…

  • Contact medical transplant teams near the potential recipients. The recipient’s surgeons will help decide if there is a good match.
  • Help transplant teams prepare the recipient once a match has been identified. The recipient will need to travel to their hospital for evaluations, tests, and preparation for surgery.
  • Coordinate the organ recovery surgery once recipients have been identified. This coordination can be complex, as it involves securing an operating room, arranging transportation for the different surgical teams, and organizing transportation of organs. Recovery surgery times may change for a number of uncontrollable reasons, but we will always be available with the latest information.

Your family might…

  • Work on more “memory making” activities.
  • Spend additional time with your loved one.
  • Return home to rest.
  • Ask questions.

Step 4: Surgery

The surgical recovery of organs takes place in the operating room. LifeCenter Northwest staff will remain with your loved one throughout the entire process. After the process is complete, your loved one will be taken to the hospital morgue.

Sometimes, organs or tissues are not able to be transplanted due to unforeseeable circumstances. Out of regard for your loved one, the surgical team will not recover any organs or tissues unless they believe they can be used to help others. Regardless of the outcome, your loved one will always be honored as a donor — for their brave, generous, and selfless decision to share life.

LifeCenter Northwest/hospital staff will…

  • Read a donor acknowledgement statement to recognize your loved one’s gift.
  • Stay with your loved one throughout the process.
  • Contact you following surgery, to share any information or updates that we may have related to the recovery.
  • Help facilitate end-of-life rituals at your request.

Your family might…

  • Conduct any prayers or observances that are important to your family.
  • Say final good-byes.
  • Return home to rest.
  • Ask questions.

Donation is a profound and powerful gift — for the recipients, of course, but also for the courageous and generous families of those who donate.

We often hear donor families say of their loved one, “That’s the kind of person they were” or “They were always so giving.”

We have talked to those same families — and the families of the people they saved — months and years later, and they still find comfort in the gift that was given.

What Happens After Donation?

In the coming weeks and months, we’ll be here for you and your family. We know that everyone grieves differently, and we always plan to help families for a minimum of 18 months after donation — to help as you move toward comfort and healing at your own pace.

We will reach out to you in a few weeks to let you know about all the support that’s available to you. We offer many resources and referrals, and we’re always available by phone, even just to call and check in.

The weeks and months following the loss of a loved one are filled with many emotions. We’ve worked with numerous families through this difficult time. We’ll be here to help you and your family understand these feelings and discover the best ways to cope with grief.

You will also receive a letter soon that tells you a little bit about your loved one’s recipients and the outcome of their transplants. In the months that follow, we will offer more opportunities for you to honor your loved one and their gift of life — to keep the memory of them present, and to share the impact of their life-saving gift.