Difference between brain death and coma: organ donation for brain death person

Brain death and coma are scientifically two completely different processes!

It is usually wrongly assumed that a brain-dead person has a chance of recovery, such as a person who has been in a coma. If you've heard that a person has suffered brain death and then recovered, it hasn't actually been brain death. Patients who have recovered are in fact in a deep coma, and after returning from a coma, their relatives or sometimes even some doctors and nurses who do not have enough information about the difference between brain death and coma have made such a misconception!

Therefore, sometimes relatives of a brain dead person mistakenly assume that he has a chance of recovery and return, so they do not consent to organ donation in the hope of recovery.

In a coma, there is a chance for some patients to recover, while brain death is, in medical terms, absolute death, and the person will never alive.

In brain death, the patient's recovery is impossible and his death within a few days is inevitable. Therefore, the opportunity to donate a brain-dead person's organ is limited to a few days!

Coma recognition

Cortical cells are highly sensitive to hypoxia, so when blood flow to these cells is stopped, they quickly become seriously and sometimes irreversibly damaged.  In this case, the person quickly loses consciousness and, depending on the extent of damage to the cerebral cortex, his reactions to environmental stimuli are reduced.  However, there is still the possibility of improving the condition and returning the consciousness of the disease that has gone into a coma.

Recognizing brain death

Brain death is the cessation of all brain activity and brainstem at the same time. a person with brain death is actually a person who, due to extensive brain damage, has been unable to communicate with his surroundings, cannot speak, does not see, does not respond to painful stimulations. A person with brain death is also unable to breathe spontaneously. Although he has a heartbeat, he has no recordable waves when we record his brain waves. His heart rate continues with the help of a ventilator and maintenance measures to keep donated organs in optimal conditions for transplantation. Brain death in medical science is absolute death and this person will never come back to life.

Persian page link : https://ehda-zendeghi.blogsky.com

Translator : Javad Eynaki Maleki

Organ donation after brain death or cardiac death (typical death)

With the consent of the parents, all those who have suffered from brain death or cardiac death (normal death) can have their organs removed and transplanted into patients.  All over the world, a few decades ago, brain death was considered equivalent to definite death, and in our country, according to the law (approved in 1379), brain death is equivalent to death.  According to the same law, organs are allowed to be removed from cases of brain death as well as cardiac death with the consent of the family and its transplantation.

Organ donation after brain death:

The main human organs such as the heart, lungs, liver, kidney ... due to having the main blood vessels are destroyed as soon as they die.  Therefore, these organs can only be removed from cases of brain death, and after removal, they can be stored for a short time and must be transplanted immediately.  The donor should not have AIDS, hepatitis or cancer and should not be older than 60 years.

Organ donation after cardiac death:

Tissues such as bones, heart valves, tendons, corneas, etc. live longer and can be removed after normal death (cardiac death) and can be stored for years.  Therefore, in cases of death (cardiac death), if the person does not have an infectious disease and timely information and consent is given, the tissue can be removed.  The donor should not have AIDS, hepatitis or cancer and should not be older than 60 years.

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Difference between brain death and coma:

Brain death is a state that the brain goes away and dies, but because the spinal cord is alive, the rest of the members  (such as the heart) remain alive for a few days; In this case, the person's breathing is discontinued and there is no medical reflection of the individual's improvement or alive, and as soon as the devices are disconnected and the person dies, and with the device and medical care, there are only a few days of "vegetative state" for the individual.

Brain death differs with anesthesia or coma, and most of the accidents occur. To confirm brain death in Iran, they will keep watching 24 hours, and after a variety of experiments and approval of the six specialist appointed by the Minister and Forensic Medicine, and the work of transplantation should be done only in government universities.

Transplant recipients:

Transplant recipients are placed on the waiting list based on blood group, intensity of need and waiting time, and at the same time as the family consent of the deceased for organ donation, a number of transplant recipients will be examined in terms of size and weight and tissue matching tests to make the organ the most suitable person.

Transplant cost:

For a member or tissue, there is no way to pay a donor or receive a recipient, but it is costing for surgical procedures and member maintenance and experiments that are covered by insurance, and the government is paying most costs.

In the operation of organ harvesting from the deceased, the body is not mutated and replaced with the harvested prosthetic organ so that the shape of the body does not change.

Having a member card donor and written will is not enough! Family satisfaction is required:

It is imperative that even if the family consent, in the event of membership in this plan or written will, fails to prevent this. So, in order to ensure that this heart desire is made, keep your relatives from having a donated card and this benevolent decision.

Persian page link : https://ehda-zendeghi.blogsky.com

Translator : Javad Eynaki Maleki

Types of Life and Death: Organ Donation = Life Donation

Types of Life:

1- Normal life: Life is for all healthy and sick people who have motor, mental and cognitive (perceptual) function.

2- Life in a coma: : Coma is a state of unconsciousness in which a person does not regain consciousness with the most painful physical stimuli and remains stable for a while. A coma is not a disease, but a sign of an illness or a reaction to an accident that has happened to a person's body; like a severe blow to the head that causes nervous shock and coma. .most of the coma that is caused by this is not longer than 4 weeks, and the patient returns to normal life, but some of those who go into a coma go to life after a while. 

3- Vegetative state: vegetative state almost always occurs following a coma.  It refers to patients who, following severe brain damage (not brain death), may survive for many years and appear conscious, without being able to communicate with their surroundings.  If, for example, only the blood supply to the cerebral cortex is disturbed, all the patient's senses and movements are lost, but the breathing and other things mentioned that originate from the brainstem remain.  In this case, we are dealing with a disease that has spontaneous breathing but no movement or perception.  Although a person seems awake (eyes open) and has a series of involuntary movements of his limbs, he has no mental or cognitive function.  In plant life, the patient does not need artificial respiration and may remain in this state for years and then return to life or die.

4. Life in locked state:  in a patient, only the blood supply of the brainstem is disrupted and the cerebral cortex remains intact, naturally we are faced with a disease that lacks any movement (except for a number of eye movements whose fibers move from outside the brainstem towards the cerebral cortex) and do not have breathing, but have full comprehensible power. This is a case that refers to a locked human condition and is the most dismal state, a disease that lacks any movement, does not have breathing, but understands all the events around it and with eye movements, can answer questions yes or no. Due to their inability to breathe, these patients should have a ventilator and may remain that way for years. The above patients rarely return and generally die due to infectious complications.

Types of death:

1- Cardiac death: Complete and irreversible devotion is a vital act, and usually the heart first fails, followed by the death of brain cells, resulting in loss of breathing, sensation, and movement.

2- Brain death: Brain death is the irreversible cessation of all brain activity of the cerebral cortex, the subcortical layer and the brainstem completely. Brain death is the irreversible cessation of all brain activity in the cerebral cortex, subcortical layer, and brainstem. It is the ability to completely control the body's brain-related respiration, so after brain death, the heart can maintain its pulse for a short time.  But without a ventilator, this pulse will stop quickly and in less than an hour (a few minutes).  Therefore, if relief is not arrived in time and artificial respiration is delivered, brain death will lead to heart death (definitive death).  However, if timely relief and artificial respiration are achieved using the equipment, it is possible to continue the heartbeat for a limited time (several days).  Also, with the use of artificial respiration, some other biological processes in the body, such as the activity of the kidneys and stomach, continue for about a week.  Without the brain, the body cannot secrete the necessary hormones to maintain the activity of biological processes, and thus the body of a person with brain death will usually not be able to survive for long.  On the other hand, the destruction of organs in the body is accompanied by the production of toxins, and the dead brain also secretes toxins that are transferred to the heart and other organs over time and disable them.  If we want to donate the organs of a person who has suffered brain death for transplantation, we have to decide within three to four days because the heart survives only a few days after brain death and after this time it disappears and will not be able to transplant.  Therefore, the organs of the body have a golden time to survive at the time of brain death, which disappears spontaneously after this time.  If the person has transplantable organs, the person does not have a specific disease and his organs are healthy, it is possible to transplant them after 3 to 4 days.

Unfortunately, the families of many brain dead people do not agree to a transplant because they do not know the difference between brain death and vegetative state and coma in the hope that the brain dead patient will return, while the probability of a brain dead patient returning is scientifically zero.

Persian page link :https://ehda-zendeghi.blogsky.com

Thank you for trying to save a human life

Translator : Javad Eynaki Maleki

Each of us can become an organ donation ambassador

According to the reporter of the Young Journalists Club of Tabriz, Farhad Choopani had suffered brain death 18 days ago due to an accident and in a godly act and with the consent of his family, five organs of his body were donated to kidney, heart and liver patients and gave them a second life, the body of this young man was buried today in his hometown of Yingjeh village of Azarshahr. (Publishdate: November 4, 2020)

The effect of the brain-dead family's awareness of the difference between brain death and coma is important for organ donation satisfaction:

Unlike a coma, there is no way for a person who has died of brain death due to brain and stem death to recover.  To confirm brain death, neurosurgeons, internal medicine and anesthesiology specialists are invited separately to visit the patient and confirm or deny the brain death to the donor.  These specialists are selected directly from the ministry without the intervention of a single unit. Unfortunately, many relatives of the brain dead person, due to lack of necessary knowledge, think that their loved one will return like a comatose person, but it is a misconception!  Within a few weeks, the complete death of the person will lead to brain death.

One of the reasons some families are reluctant to donate their beloved brain-dead organ is to deny brain death.  Because they think that when their loved one moves his chest, he is alive!  While they do not realize that their loved one's heart is beating due to artificial respiration, they do not know that after several days during the production of toxins in the body, the heart of the brain dead person will definitely stop moving.

Therefore, each of us can become an organ donation ambassador by registering an organ donation card and talking about this issue in the family and friends, and provide the role of creating awareness of families about the difference between brain death and coma.

With a good health wish

Thank you for trying to save a human life

Translator : Javad Eynaki Maleki

Persian page link :https://ehda-zendeghi.blogsky.com

All about brain death-The need to create a culture for organ donation (in brain death cases)

All about brain death:

In brain death, blood flow to the brain is stopped, oxygen is not supplied to it. The brain loses all its function and suffers irreversible damage.  Although other organs, including the heart, liver, and kidneys, are still functioning after brain death, they will gradually decline over the next few days.  The brain dead patient does not speak, does not see, does not respond to any external stimuli, and will not be able to breathe without the use of a ventilator.

What are the most common causes of brain death?

Traffic accidents, severe head trauma, falling from height, waterboarding, poisonings, internal brain bleeding as well as stroke.

How does brain death occur?

Any severe damage to the brain can lead to tissue swelling. Since the brain is located in a closed space (skull bone) and there is no room for this volume increase, it puts pressure on the lower parts of the brain (brainstem), prevents circulation to the upper parts and prevents oxygenation more than ever.

This process may take a few minutes or days. The heart continues to function with the help of the ventilator, delivering oxygen to other organs, while brain tissue and brainstem, which are responsible for controlling breathing and heart rate, are deprived of this vital substance (oxygen) and die.

Why does the patient have heart rate and respiration for some time in brain death?

 The heart continues to beat as long as it has oxygen.  In the brain-dead patient, the ventilator will provide the oxygen needed for the heartbeat and will fail as soon as the device is separated from the heart patient.

What is a coma? Is it brain death?

Coma is a type of brain dysfunction that causes a severe decrease in the level of consciousness and does not respond to any of the stimulations around it. In a coma, there is a chance of recovery for some patients, while in brain death, the patient's recovery is impossible and his death is certain within a few days.

What is vegetable life and what is different with brain death?

 Vegetable life is completely different from brain death. 

This situation occurs almost always following the coma. Although the person appears to be awake (his eyes is open) and has a series of universal movements, there is no mental and cognitive performance. These are actually patients who seek extreme brain damage for many years of life, and in view, without being able to communicate with their surroundings.

Can the patient's appearance indicate that he has suffered brain death?

 No, a person with brain death is like someone who is fast asleep.  Her lungs are filled with air through a ventilator, her heart is beating due to oxygen, and her skin is even warm and pink.

Does the patient feel pain following brain death?

 No.  After brain death, there will be no pain or sorrow in humans.

Have there been cases of brain death that have improved?

 No, it is not possible for a brain dead patient to recover and return at all.  The things you've heard about brain death and then recovery are not really brain death.

 These patients are in a deep coma, but their relatives, or even some doctors and nurses who do not know enough about the difference between brain death and coma, have made such a misconception.

Thank you for trying to save a human life

Translator : Javad Eynaki Maleki

Persian page link :https://ehda-zendeghi.blogsky.com/