"Non-Heart-Beating," or "Cardiac Death," organ donation: Why we should care

Mohamed Y. Rady, Joseph L. Verheijde, Joan McGregor

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Organ donation after cessation of cardiac pump activity is referred to as non-heart-beating organ donation (NHBOD). NHBOD donors can be neurologically intact; they do not fulfill the brain death criteria prior to cessation of cardiac pump activity. For hospitals to participate in NHBOD, they must comply with a newly introduced federal requirement for ICU patients whose deaths are considered imminent after withdrawal of life support. This report describes issues related to NHBOD. Methods: A nonstructured review of selected publications and Web sites was undertaken. Results: Scientific evidence from autoresuscitation and extracorporeal perfusion suggests that verifying cardiorespiratory arrest lasting 2-5 minutes does not uniformly comply with the dead donor rule, so that the process of organ procurement can be the irreversible event defining death in organ donors. The interest of organ procurement organizations and affiliates in maximizing recovery of transplantable organs introduces self-serving bias in gaining consent for organ donation and abandons the basic tenet of obtaining true informed consent. The impact of donor management and procurement protocols on end-of-life (EOL) care and the potential trade-off are not disclosed, raising concern about whether potential donors and their families are fully informed before consenting to donation. Conclusions: The use of comprehensive quality indicators for EOL care can determine the impact of NHBOD on care offered to donors and the effects on families and health care providers. Detailed evaluation of NHBOD will enable the public to make informed decisions about participating in this type of organ donation.

Original languageEnglish (US)
Pages (from-to)324-334
Number of pages11
JournalJournal of Hospital Medicine
Volume2
Issue number5
DOIs
StatePublished - Sep 2007

Fingerprint

Tissue and Organ Procurement
Tissue Donors
Terminal Care
Brain Death
Family Health
Informed Consent
Health Personnel
Publications
Perfusion
Organizations

Keywords

  • Cardiorespiratory death
  • End-of-life care
  • Ethics
  • Informed consent
  • Non-heart beating donation
  • Organ donation
  • Organ procurement

ASJC Scopus subject areas

  • Health Policy
  • Assessment and Diagnosis
  • Care Planning
  • Fundamentals and skills
  • Leadership and Management

Cite this

"Non-Heart-Beating," or "Cardiac Death," organ donation : Why we should care. / Rady, Mohamed Y.; Verheijde, Joseph L.; McGregor, Joan.

In: Journal of Hospital Medicine, Vol. 2, No. 5, 09.2007, p. 324-334.

Research output: Contribution to journalArticle

Rady, Mohamed Y. ; Verheijde, Joseph L. ; McGregor, Joan. / "Non-Heart-Beating," or "Cardiac Death," organ donation : Why we should care. In: Journal of Hospital Medicine. 2007 ; Vol. 2, No. 5. pp. 324-334.
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