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The Nasty Side of Organ Transplanting.

Chapter 9

Types of Donors

"Brain dead” donors: Humans with beating hearts and blood circulation declared dead due to serious brain injury. They're called “heart-beating cadavers” within the medical profession who also refer to them as “dead” when speaking to the general public.

Biologically dead donors: True corpses without heart beat, respiration or brain activity. They are harvested for virtually everything except vital organs. These donors have died from injuries and illness and not from the organ harvesting process.

Living donors

1. 1. Voluntary: Humans in good health donating a kidney, bone marrow, blood, section of liver or lung. They're expected to remain alive after donation though a small number die from the procedure. Donors giving bones via amputations and hip replacement surgery are also classed as living donors.
2. 2.  Involuntary: Also called compelled donors who through a court order are forced to “donate” a kidney to a family member.^[55] In China, prisoners condemned to death also “donate” organs as may do members of Falun Gong.^[56]
3. 3.  Coerced: These donors feel obligated to provide an organ to a relative and don't feel strong enough to say, “no”.^[57]
4. 4.  Enticed: Money motivates these donors who usually come from countries with extremely poor people.

Non Heart-Beating Donors (also known as Donation after Cardiac Death)

These are often confused with biologically dead donors because both categories of donors are used when their hearts have stopped beating. The comparison ends there.

1. 1. Controlled non heart-beating donors: (See below). These are seriously injured or diseased people with beating hearts who are dependent on mechanical ventilation and, although not certifiable “brain dead", are nevertheless expected to die soon. They're perfused with organ preserving fluids and then life support is removed to allow death to occur (because cardiac arrest follows). Harvesters wait two to ten minutes and then cut open their bodies. The controversy is about how far gone these donors are in the dying process when the surgery begins. Many or most of them could be resuscitated to their pre-arrest state after such short periods of circulatory arrest. In up to 10% of them, the expected cardiac arrest fails to occur soon after mechanical ventilation is stopped and, somewhat embarrassingly for the harvesters, they are returned to the ward for resumption of therapeutic treatment. This is despite being full of blood thinners and blood vessel dilators, and with raised blood pressure that has damaged their health further.^[58]
2. 2.Uncontrolled non-heart-beating donors: These “donation after cardiac death” donors die suddenly from various causes like strokes, heart attacks and car crashes. They are generally unwelcome donors but kidneys harvested within an hour of heart stoppage may be transplanted.^[59]