Organ transplantation is a modern medical marvel responsible for saving countless lives. However myth and misinformation continue to hinder organ donation, and this results in a shortage of vital organs. Organs used in transplant come from living donors, donors declared brain dead by neurologic criteria, or donors declared dead by cardiopulmonary criteria. This article explores the practical and ethical conundrums and barriers critical care providers face regarding organ donation from deceased donors in the intensive care unit (ICU).

Brain death is defined as the irreversible loss of all brain function, including that in the brainstem. There are 3 cardinal findings in brain death: coma, absence of brainstem reflexes, and apnea. Patients who meet clinical criteria for brain death are medically and legally dead as established by the US Uniform Determination of Death Act, and discussion of organ donation may proceed. Although they...

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