"Mentally enormous strength required"
All content is checked by medical journalists.What is brain death? Up to what age can you donate organs? The heart specialist Dr. Tobias Deuse
Dr. Tobias Deuse
Dr. Tobias Deuse is a senior physician at the Clinic and Polyclinic for Cardiovascular Surgery at the University Heart Center Hamburg (UHZ).
Up to what age can I donate organs?
In principle, anyone whose organs are healthy and functional is suitable as a donor. But you have to differentiate. The liver and kidneys usually function without any problems into old age. The heart and lungs are a little more picky about quality. A donor heart can enter a critical phase during transport until it is reconnected to the blood supply, it becomes ischemic, that is, the blood supply is insufficient. The older the donor, the less time the heart can survive without blood flow. At our center, we accept a donor's heart up to approximately 65 years of age.
How can I be sure that I am really dead before my heart is removed?
In Germany, according to the Transplantation Act, two independent doctors have to prove and record brain death: irreversible damage to the central nervous system. There are clinical tests for this that check the brainstem reflexes, the blood flow in the brain and independent breathing - but only when anesthetics are no longer effective.
Neither the intensive care doctor nor the transplant doctor may perform these tests to avoid a conflict of interest. So far, however, there is no known case in which a patient was declared brain dead and then woke up again.
How long can you live with a donor heart?
The survival rate after ten years is around 50 percent. These statistics also include patients who die for various reasons in the early phase after the transplant, for example because the organ was damaged during transport. Young and old patients, who would live for different lengths of time even in a healthy state, are also included. We have many patients who have lived extremely well with a donor heart for a very long time. In principle, the organs are not limited to ten years.
How important is the mental and physical condition of the organ recipient for a successful transplant?
Quite crucial. I always tell patients: we can only replace one organ for them. Everything else has to work. Patients should keep their muscles fit before the procedure. They also need to get up quickly after the operation. And that works much better with those who are physically fit.
In view of the desperate donor situation, enormous mental strength is required of the patient today. At the moment, the waiting time for a donor heart is not infrequently nine to ten months. The patients spend this time on the ward: without privacy, the bed neighbors change. Who would you want to share a hotel room with for so long? We have our own department for transplant psychology that supports the patients during this time.
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