Brain Death in the OR

° Prep and drape

° The patient is prepped and draped from the chin to the pubis and to the anterior axillary line.

° Initial incision

° Initial incision is from sternal notch to the lower middle quadrant and the chest is opened.

° Dissection

° Organs are isolated for recovery.

° Cross-clamp

° The aorta is cross-clamped.

° Flushes and icing

° The organs are flushed and iced as quickly as possible following cross-clamp of the aorta.

° Removal of organs

° Organs are recovered with the necessary vasculature for transplantation.

° Back table and packaging

° Each organ is inspected, packaged, and appropriate paperwork and documentation is completed.

° Organ transport

° Organs are handed off to the recovering surgeon or transported to the appropriate transplant center.

DCD in the OR

° Prep and drape

° The patient is prepped and draped from the chin to the pubis and to the anterior axillary line.

° In some instances, the prep and drape will not occur until after death declaration depending on hospital policy.

° Extubation

° The attending physician will extubate the patient.

° Extubation typically occurs in the OR, but may occur in other locations depending on logistical concerns and hospital policy.

° Death declaration by hospital staff

° The attending physician will declare death upon meeting hospital parameters for death declaration.

° Initial incision 5 minutes after death