Life Goes On: Organ Donation Thread

[morbidT]

'Lungs don't die when you do': New transplant program might ease shortages

http://www.nbcnews.com/health/lungs-...uld-2D11603373

The pair of lungs sits inside a clear dome, gently inflating as doctors measure how well they'll breathe if implanted into a patient who desperately needs a new set.

It's a little-known twist of nature — your lungs can live on for a while after you die. The air left inside keeps them from deteriorating right away as other organs do.

An innovative experiment now aims to use that hour or more window of time to boost lung transplants by allowing donations from people who suddenly collapse and die at home instead of in a hospital.

"There aren't enough lungs. We're burying them," said Dr. Thomas Egan of the University of North Carolina, Chapel Hill, who is leading the project. "It turns out your lungs don't die when you do."

This is a new frontier for transplants.

Today, registered organ donors don't get to fulfill that last wish if they die outside of a hospital. The U.S. doesn't have a system to recover their organs quickly enough. It can be an added shock to grieving families, and a waste of potentially good organs that might ease transplant shortages.

"The general public does not understand how hard it is to become an organ donor. They assume if they sign their card, when they die, then it will happen," said bioethicist Arthur Caplan of New York University's Langone Medical Center. "Only 2 to 3 percent of people die in circumstances that let them be organ donors."

Excellent articles, RBW!

The bold is extremely important, IMO.

This article is, basically, suggesting a return to how organ donation originally started, except with a little twist. Time. Organ donation started out with donors who suffered cardiac arrest. Whether it be trauma or sudden collapse. Unfortunately, the organs didn't fair well. When brain death criteria was introduced(becoming a donor while suffering brain death on a ventilator) transplant survival rates soared. The key is organ perfusion.

DCD, Donation After Cardiac Death (formerly known as NHBD-Non Heart Beating Donor), has never stopped occurring, it just isn't talked about as much as BD donors. At this point. DCD is done in a controlled environment and these are people who still have at least one brain stem reflex left. They are not people who are in vegetative states or comas. These are people who will never recover from their current state, but have not advanced to clinical brain death. Back in the day the person would be extubated on the hospital floor and once the person took their last breath there would be a 5 minute waiting period and then cardiac death pronounced. The procurement team would wheel the donor down to the OR, the donor would be quickly prepped, and the kidneys (sometimes pancreas and liver) would be procured. I would be sitting down in the OR waiting to receive the phone call that the donor expired. We used to wait 3 hours, but it was found the organs didn't fair well. Then we went to 1- 1 /12 hours. Now, the donors are extubated in the OR and the procurement team(s) have to wait outside the OR until the person is pronounced dead. Once the pronouncement is made the procurement team works quickly to remove the organs. Kidneys are placed on the pump and do very well.

Hearts and lungs are currently being placed on machines to help preserve them for transplant in France. Hearts are next. The machines are manufactured in the U.S., but have not been approved here. I wonder if the clinical trial mentioned in NC is utilizing this machine.

Pretty awesome stuff.




I had to snip