Brain death is the total and irreversible loss of all brain function (including involuntary activity necessary to sustain life) and the condition under which the donation of vital organs most commonly takes place.
Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes total cessation of all brain stem functions. Brain death is not coma or persistent vegetative state. A patient who is in a coma or persistent vegetative state typically has some brain stem function (which controls breathing) and possibly other brain function. When a person is brain dead, no part of the brain is functioning any longer.
In India, brain stem death is determined in the hospital by a panel of four physicians that includes the treating physician, a physician representing the treating hospital, an independent specialist, and a neurologist or neurosurgeon. The tests are done twice with a gap of six hours to confirm death. This team is not associated with the transplantation team.
A brain dead patient looks to be asleep, is warm to touch and appears to breath, even though it is through the ventilator. The family, therefore, finds it difficult to understand the concept of brain stem death when this tragic situation is explained to them. Once the family has accepted that their loved one is dead, they are presented with the option of organ and tissue donation, in order to give life to others.
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