PMID- 17935243
OWN - NLM
STAT- MEDLINE
DCOM- 20071130
LR  - 20150220
IS  - 1553-5606 (Electronic)
IS  - 1553-5592 (Linking)
VI  - 2
IP  - 5
DP  - 2007 Sep
TI  - "Non-heart-beating," or "cardiac death," organ donation: why we should care.
PG  - 324-34
AB  - 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.
CI  - (c) 2007 Society of Hospital Medicine.
FAU - Rady, Mohamed Y
AU  - Rady MY
AD  - Department of Critical Care Medicine, Mayo Clinic Hospital, Mayo Clinic Arizona, 
      Phoenix, AZ 85054, USA. rady.mohamed@mayo.edu
FAU - Verheijde, Joseph L
AU  - Verheijde JL
FAU - McGregor, Joan
AU  - McGregor J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Hosp Med
JT  - Journal of hospital medicine
JID - 101271025
SB  - IM
MH  - Death
MH  - Decision Making
MH  - Humans
MH  - *Practice Guidelines as Topic
MH  - Quality Assurance, Health Care/methods
MH  - Terminal Care/standards
MH  - Third-Party Consent/legislation & jurisprudence
MH  - Tissue Donors/*legislation & jurisprudence
MH  - Tissue and Organ Procurement/*legislation & jurisprudence/*standards
MH  - United States
RF  - 54
EDAT- 2007/10/16 09:00
MHDA- 2007/12/06 09:00
CRDT- 2007/10/16 09:00
PHST- 2007/10/16 09:00 [pubmed]
PHST- 2007/12/06 09:00 [medline]
PHST- 2007/10/16 09:00 [entrez]
AID - 10.1002/jhm.204 [doi]
PST - ppublish
SO  - J Hosp Med. 2007 Sep;2(5):324-34. doi: 10.1002/jhm.204.