Practice The Competent Novice

Organ donation

BMJ 2010; 341 doi: (Published 15 November 2010) Cite this as: BMJ 2010;341:c6009
  1. Paul J Frost, clinical senior lecturer and consultant in intensive care medicine13,
  2. Stephen Leadbeatter, senior lecturer in forensic pathology2,
  3. Matthew P Wise, consultant in intensive care medicine3
  1. 1Division of Medical Education, Cardiff University School of Medicine, Cardiff CF14 4XN
  2. 2Department of Medical Genetics, Pathology and Haematology, University Hospital of Wales, Cardiff
  3. 3Critical Care Directorate, University Hospital of Wales
  1. Correspondence to: P J Frost FrostP1{at}
  • Accepted 28 September 2010

Junior doctors working in general hospitals are likely to encounter organ donation from deceased donors. They can gain understanding of this complex process by accompanying senior colleagues

Key points

  • Organ and tissue transplantation can save and greatly improve lives, but a paucity of organs means that many patients die awaiting transplantation

  • Junior doctors’ lack of familiarity with donation contributes to low donation rates, but donation should be considered as a routine part of end of life management

  • Specialist nurses for organ donation can be contacted through the hospital switchboard and can advise junior doctors on any aspect of donation

  • Families are more willing to consent to donation if they understand brain stem death and perceive that their relative has received high quality care.

Organ and tissue transplantation leads to dramatic improvement in patients’ quality of life and outcomes. Unfortunately, many people die while waiting for a transplant because of the paucity of available organs.1 2 Aside from this human burden, the economic impact of this shortage is considerable. The annual cost of treating a patient with dialysis is £23 177 (€26 126, $36 319) compared with an outlay of £42 025 for a renal transplant followed by £6500 a year.2 Donation may provide some comfort to a grieving family and have a beneficial effect on the bereavement process.3 Despite these affirmative aspects of donation, evidence suggests that medical students and junior doctors lack familiarity with this issue, contributing to low donation rates.4 5

This article focuses on donation of organs and tissues from deceased, not live, adults, circumstances that are likely to be encountered by junior doctors working in any UK general hospital. Deceased donors may be brain stem dead with a beating heart (sustained by mechanical ventilation) or asystolic (cardiac death). In the UK there were 959 deceased donors in 2009-10, …

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