UW Hospital a leader in alternative to brain death organ donation

Wisconsin State Journal | David Wahlberg

Editors note: It is important to understand the following:

  • Family in partnership with their physician has made the descison to withdraw life sustaining support. This difficult decision by families take place many times a day in hospital ICU units often because of an individual's wishes not to be kept alive on a machine.
  • Only after the decision to withdraw care is made, families are giving the opportunity for donation; if patient is not a registered donor, family will need to consent to donation.
  • In this case, patient is a registered organ donor and has already given her permission for donation to take place after she is declared dead; no further authorization is required.
  • In the case of a registered donor, the family, hospital and organ procurement organization are obligated to fulfill the wishes of the donor.
Terry Flugaur, of Wisconsin Rapids, looks through a memory book of her daughter, Kiley Hackl, of Sun Prairie, a mother of five who died at UW Hospital at age 32 in 2013. Hackl, who was left with minimal brain function from a clot in her brain, donated organs after life support was removed and her heart stopped. UW Hospital is a leader in the technique, called donation after circulatory death.

Kiley Hackl, a fitness buff, was in a kickboxing class in Sun Prairie when she collapsed.

A helicopter took the 32-year-old mother of five to UW Hospital, where scans showed a clot had destroyed most of her brain. Doctors said her condition was futile and irreversible, but she still had minimal brain activity.

In many parts of the country, that would have prevented her from being an organ donor. Doctors typically declare a person brain dead, meaning they have no brain function at all, before removing organs while a ventilator keeps the heart beating.

But after Hackl’s family decided to withdraw life support, they learned that Hackl, who had signed up to be an organ donor, could still be one once her heart stopped and her body shut down — known as circulatory death.

UW Hospital is a leader in donation after circulatory death, an alternative to donation after brain death. The procedure, which is somewhat controversial, allows people with severe, irreversible brain injuries or in late stages of terminal illnesses to donate organs after a controlled death.

As loved ones watched, doctors removed Hackl’s breathing tube in the operating room and waited for her heart to stop. A few minutes later, they declared death and recovered her organs. Continue reading