Abstract
The need for a reliable means to diagnose brain stem death (BSD) was met in the UK by a Code of Practice drawn up in 1976. The diagnostic criteria are classified as essential preconditions, exclusions and clinical tests. Practical advice on performance of the tests is given. When BSD has been diagnosed the patient's suitability for organ donation should be considered. Patient eligibility plus practical, ethical and legal issues concerning consent for donation are discussed. After consent has been obtained, the goal of intensive care is to ensure the organs are maintained in an optimum condition before and during the donor operation. There is an increasing shortfall in organs available for transplantation owing to improvements in health care, road safety and imaging. Suggested means of increasing the supply of organs include opt-out policies, elective ventilation, asystolic donation and live-related kidney donation.
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