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Brain dead patients have to be strapped to the operating table. They are treated with immobilizing medication.
During incision the brain dead patient may react with rising blood pressure, heart beat and adrenaline. These reactions are considered to be signs of stress or pain in other operations. As a precaution many anaesthetists treat the brain dead patient with pain killers and anaesthesia, others don't. Nobody can tell for sure what a brain dead person feels and perceives.
Abdomen and thorax are opened from neck to pubic bone. The skin flaps are fixed to a kind of vessel which is filled with up to 15 litres of an ice-cold fluid. The organs are irrigated with an ice-cold perfusion, the blood is drawn off. The doctors lay the organs open while the heart is still beating and prepare them for the removal.
The ventilators and monitors are turned off after the removal.
A peaceful and protected dying process of the brain dead patient, attended by next of kin, is impossible in case of organ removal. The transplant doctors who come in teams to remove the organs in turns are the only attendants instead.