Where Will my New Pancreas Come From?
Donation after Brain Death
The most common type of organ donor is a person who suffered a head injury that caused brain
death. “Brain death” occurs when someone does not get enough oxygen. This causes the brain
to stop working. It is often due to trauma or a stroke. Doctors can tell when someone is brain
dead by testing certain reflexes controlled by the brain. They use machines that look at blood
flow to the brain. The brain controls breathing so people who are brain dead are in a hospital on
a breathing machine called a ventilator. Because of the breathing tube and certain medicines, the
person’s body can function even after brain death. This allows the heart to keep beating and
supply the pancreas and other organs with blood and oxygen until a transplant team can arrive.
Donation after Circulatory Death
Sometimes the trauma is so severe that doctors cannot save the patient’s life, but they do not
meet the measures for “brain death.” The doctors then discuss with the patient’s family whether
or not to remove life support. If the family chooses to remove life support, the machines are
turned off. The patient is allowed to die peacefully. Sometimes, these patients can be organ
donors. Transplant teams are called and are present when the life support is turned off. After the
heart stops beating and the patient is declared dead by the doctor, the transplant teams can
remove the organs. This is called Donation after Circulatory Death (DCD). Because the heart
has stopped beating in these donors, there is a lack of blood flow for a short time to the organs as
they are removed. Because of this, a pancreas from a DCD donor may sometimes take a few
days to make enough insulin to control glucose levels. The blood pancreas enzyme level may
also rise in the first few days after transplant. But, the outcomes for patients who receive a
pancreas from DCD donors are the same as with brain death donors.
“Increased Risk” Donors
You may be offered an organ from a deceased donor that is thought to be high risk for spreading
certain infections according to the 2013 Public Health Service (PHS)guidelines. Donors are
considered “increased risk” because of what the PHS deems to be a high risk behavior such as
prostitution, intravenous drug use, or homosexuality. It is not the norm to accept organs from
such donors unless we feel that the good far outweighs the would-be risk. Blood tests are done
on potential donors to look for a virus such as HIV, Hepatitis B, or Hepatitis C. No test is
perfect, and false negative results rarely occur. Using data from organ, tissue, and blood donors
we know there is a small chance, between 1 in 60,000 to 1 in 2,000,000, that an infectious agent
could be passed on. We believe that the risks of getting this type of pancreas are very small or
we would not suggest that you accept it. The transplant coordinator will inform you at the time
that the pancreas is offered if it is from an increased risk donor. You would then decide whether
to accept this type of pancreas. If you choose not to accept it, you will not lose your place on the
How do I choose?
Members of the transplant team can provide more information about this topic. They can help
you choose the type of transplant that may be best for your own case.
What will I be told about my donor?
Patient confidentiality laws limit how much we can tell you about your donor. We cannot tell
you the donor’s age, gender, or personal or health history. Guidelines for allocating pancreases
are set by the United Network for Organ Sharing (UNOS). The Organ Procurement
Organization (OPO) informs the UW Transplant Program when a pancreas is found and who is
number one on the UNOS list to receive it. The OPO has a thorough screening for all would-be
donors to attempt to find any illness that could affect the transplant organ or the patient who
receives it. Screening for such an illness can be limited by time constraints between the time that
the donor was injured and the organ obtained. We use our best knowledge and judgment to
attempt to ensure every organ we transplant will function and will in no way harm the patient
who receives it.
The Spanish version of this Health Facts for You is #6760.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2016. University of Wisconsin Hospital
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6696