Examining Delays in the Organ Recovery Process0

Organ recovery refers to the removal, preservation and use of human organs and tissue from the bodies of the recently deceased to be used in surgical transplants on the living.  Though mired in ethical debate and heavily regulated, organ donation in the United States has largely become an accepted medical practice.  As the number of people needing a transplant continues to rise faster than the number of donors, this is good news.

It is important to note that total organ donation is only considered once it is clear that a patient has no hope of survival. Until that time, the focus will always be on healing the patient at hand. The prospect of gathering viable organs from a severely injured patient plays no role whatsoever in a doctor’s overall diagnosis or treatment, as every doctor is medically and ethically obligated to provide each patient with the best quality care until such time as brain death occurs.  Pledging to donate an organ will never place the patient in added jeopardy, though it may save a stranger from harm.

The concept of brain death, however, is not always so simple. A recent study of the organ recovery process published in Neurology, a journal of the American Academy of Neurology, concludes that a second exam on a person who is considered brain dead may be unnecessary given the impact it has on organ donation rates.

Scientists reviewed the cases of 1,229 adults and 82 children ages one and older pronounced “brain dead.” According to the study author Dana Lustbader, MD, FCCM, FCCP, with The North Shore LIJ Health System in Manhasset, New York: “One of the most disturbing findings of our study is the prolonged anguish imposed on grieving families in the intensive care unit waiting for the second brain death exam. Not only is the opportunity for organ donation reduced, but families may endure unnecessary suffering while waiting an average of 19 hours for the second exam to be completed.”

Dr. Lustbader further explains: “Since organ viability decreases the longer a person is brain dead, our results show that conducting more than one brain death examination results in the loss of potentially life-saving organs. A repeat exam adds an extra day of intensive care resulting in additional costs of about a million dollars per year in the New York region alone.”

The study concluded that everyone declared brain dead in the first study had no restored brain stem function in the second exam.  Within the study, 166 people (12%) sustained a cardiac arrest in between exams or shortly after the second exam, making them ineligible for organ donation.

Additional source at CNN.com.

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