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Organ Donation After Brainstem Death — FRCA Final MCQ

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ModerateMedicolegal & EthicsOrgan Donation After Brainstem DeathFRCA Final

A 22-year-old man (ASA I, 85 kg) sustains a traumatic brain injury with intracranial haemorrhage. He is intubated, ventilated, and paralysed. After 48 hours of maximal medical management, he progresses to brainstem death. His family agree to organ donation. His blood group is O negative. Which organ can potentially be retrieved for transplantation from a brainstem-dead donor on a noradrenaline infusion?

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Correct answer: B — Heart, lungs, liver, kidneys, pancreas, and small bowel

Donation after brainstem death (DBD) allows retrieval of virtually all solid organs including heart, lungs, liver, kidneys, pancreas, and small bowel, as well as tissues (corneas, bone, skin, heart valves). Vasopressor use is NOT a contraindication to organ donation. Careful donor optimisation (fluid management, vasopressin to replace noradrenaline, hormone replacement therapy with methylprednisolone, T3/T4, desmopressin, and insulin) maximises the number and quality of organs retrieved. NHS Blood and Transplant coordinates this process.

Reference: NICE – 2016 – CG135 Organ donation; Academy of Medical Royal Colleges – 2008 – Code of practice for death diagnosis