Beating Heart Donors

Surgeons retrieving organs for transplant just after a donor’s heart stops beating would no longer have to wait at least two minutes to be sure the heart doesn’t spontaneously start beating again if a new policy is passed by the National Procurement Organization.

Donation by Cardia Death is the same term a as non beating heart donor. However, if the rule revision is passed it can now be called:  “donation after circulatory death.” That terminology, advocates say, is more accurate, given that the heart might not necessarily be “dead” before “death” can be declared.

Regardless of what they call it, non heart beat donor, donation by cardiac death or donation after circulatory death it still involves surgeons taking organs within minutes of respirators and other forms of life support being cut off from hospitalized patients who still have at least some brain activity.”

Most hearts, lungs, kidneys, livers and other organs obtained for transplants in the United States have come from patients who have been pronounced “brain dead” in a hospital.

The dead donor rule

The dead donor rule basically says that before an organ can be harvest the patient must be declared dead.

The “dead-donor rule” refers to two accepted ‘ethical norms’ that govern the practice of organ harvesting before transplantation:

1) vital organs should be taken only from dead patients,

2) living patients should not be killed for or by organ procurement.

If you have a loved one in a critical condition or a coma, you will be asked about donating after cardiac death or circulatory death. We were with my son by an Organ Procurement agent hovering around us. They did this when we disputed “brain death” as being really dead. (details in the book)

“There’s a fine line between methods that are pioneering and methods that are predatory,” said Leslie M. Whetstine, a bioethicist at Walsh University in Ohio. “This seems to me to be in the latter category. It’s ghoulish.”There’s no consensus regarding how long CPR must be performed before death is determined as irreversible. In other words, when in the resuscitation process does the patient transition from being treated as a patient to a donor?” Whetstine asked. “Are such patients really dead after resuscitation efforts end and after a time interval of two minutes of cessation of circulation elapses?”

This is a really good article by Discover Magazine on the The Beating Heart Donors | DiscoverMagazine.com.

Here is a comment on MercatorNet.com by an operating room nurse:

I’m an Operating Room Nurse @ a trauma hospital that performs harvest on brain dead patients. We recently started to do harvest on patients that are not declared brain dead, but their prognosis is considered grave and not recoverable. I myself refuse to be involved in this type of harvest. The patient is brought into the Operating Room then prepped and draped ready to cut. The patient is then disconnected from the ventilator. The clock starts and the patient has an hour to “die” on the table as we all stand around and wait for the absence of cardiac activity. My fellow co-workers who have been involved in this type of harvest tell some disturbing stories. Patients who show signs of panic once the assisted ventilation is removed: Squirming, arm and leg movements, facial distortion. Behavior one would expect to see by someone who is being suffocated. We’ve been told that if a patient’s family member wants to be there at the time of death, we are suppose to accommodate them. I can’t imagine wanting to see someone I love die in such a terrible manner. If the patient still has a heart beat after an hour, we are to remove the patient from the Operating Room and return them back to their hospital room. This is without any ventilation or support of any kind. Just waiting for the patient to expire.

Personally this is highly unusual to let a family anywhere near the operating room but this is what the nurse said.

Flickr Photo Credit

***I haven’t written in over a week, Real Estate in Ann Arbor is crazy busy right now.****