Cerebrovascular physiology of circulatory death in patients undergoing medical assistance in dying (MAiD)

Patients undergoing medical assistance in dying (MAiD) can qualify as organ donors. Donation commences after death, which is declared when blood pressure drops below a certain threshold. We believe that a low enough blood pressure means the brain is no longer receiving blood, which represents true death, after which donation can begin. The time it takes for blood pressure to become low enough (ischemic time) can cause damage to organs because of reduced blood flow. If it takes too long for blood pressure to reach the threshold, too much damage occurs, and organs are discarded. The threshold value of blood pressure is based on studies of critically ill patients in the intensive care unit. We are not sure if the same thresholds would apply to patients undergoing MAiD, as their underlying physiology is different. We think the threshold would be higher for patients undergoing MAiD. We will measure blood flow velocity to the brain in patients undergoing MAiD using transcranial doppler. If blood flow stops at higher blood pressure levels than currently used cutoffs, this would reduce ischemic time and reduce damage to potential donated organs. We will report our results in scientific journals and through organ donation organizations.