Rethinking Healthcare

Radical proposal to tackle organ shortage: keep brain dead patients alive

Radical proposal to tackle organ shortage: keep brain dead patients alive

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Some other ideas in the British Medical Association report on organ donation includes: restarting hearts in people who've died of heart failure and covering funeral expenses for donors.

This week, the British Medical Association released a report looking at new sources of organ donation – posing many tricky questions in order to redress the country’s shortage.

While donation rates in the UK have improved by 25% in the last few years, 500-1000 people still die a year waiting for a transplant.

Some highlights of the report [pdf] on organ donation policy:

1. Restarting hearts from people who have just died of heart failure.

Keeping the heart beating helps preserve it longer. Surgeons could remove the heart of someone who has just suffered circulatory death, maintain its function by putting blood and oxygen into it, and give it to a patient who needs a new heart, the Guardian reports. This procedure is used successfully in the US.

2. Keeping brain dead patients alive on ventilators.

While such patients are often put on artificial ventilation for a short while to enable their relatives to say goodbye, elective ventilation is different, the Telegraph explains. It involves starting ventilation, once it is recognized that the patient is close to death, with the specific intention of facilitating organ donation.

3. Creating a test to guarantee that potential donor babies are brain dead.

Brain stem death is when there are no longer any reflexes through the stalk connecting the brain to the spinal cord. It’s legally considered a sign of death in the UK, allowing doctors to identify potential donors before their organs begin to deteriorate. There’s currently no test in the UK for diagnosing brain stem death in babies less than 2 months old. New Scientist reports.

4. Offering incentives for donating.

The report says other options could include ‘mandated choice,’ where all adults are forced to decide whether they want to become an organ donor; ‘reciprocity,’ where those who donate organs (or sign up to donate after their death) receive priority should they themselves require a transplant; or some form of incentive or compensation for donors (for example, paying for organs or covering funeral expenses). BBC reports.

5. Opting out.

It concluded that the best option to increase organ donation rates in the UK would be to make donation the default, a presumption from which people must opt out. There’s also the removing of barriers that lead families to refuse organ donation because they don't know what their relatives' wishes were.

Image by Beth.R via Flickr

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Janet Fang

Contributing Editor

Janet Fang has written for Nature, Discover and the Point Reyes Light. She is currently a lab technician at Lamont-Doherty Earth Observatory. She holds degrees from the University of California, Berkeley and Columbia University. She is based in New York. Follow her on Twitter. Disclosure