There are two sources of organs for transplantation namely cadaveric or live. Cadaveric donors may be brainstem dead (heart-beating) donors or non-heart-beating donors (after cardiorespiratory arrest). Mode and location of death are major determinants of which organ or tissue may be donated. Organ donation tends to be mainly from an ICU setting, although occasionally from the emergency room as well. Live donors consent to donating a non-vital organ while otherwise well. Commonly transplanted organs include heart, lung, pancreas, liver, kidneys and small bowel. Commonly transplanted tissue includes eye tissue (corneas), heart valves, bone, menisci, tendons and skin.

Brainstem death

Acceptance of the concept of brainstem death has allowed donation from heart-beating donors. Of cadaveric transplants, heart-beating donors make up 80% of the donor pool in the UK. 20% of donors are non-heart beating. The diagnosis of brainstem death should be made by two doctors who have been registered for more than five years and are competent in the field. At least one of the doctors should be a consultant. Testing involves following set criteria, and repeating to remove the risk of observer error, although the time interval between tests is a matter of clinical judgement.Death is not pronounced until both sets of tests have been completed, and the legal time of death is that of the completion of the first set of tests.