Transplant organs - Shorts

Townsend Letter for Doctors and Patients,  Dec, 2002  by Jule Klotter

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A Swiss study may help ease the shortage of transplant organs and bypass some of the ethical dilemmas posed by the need for suitable organs. An Associated Press article, dated July 25, 2002, reported that survival rates among patients receiving a kidney from a dead body and those receiving a kidney from a living body were nearly identical, according to a study by doctors at University Hospital Zurich. The doctors followed about 250 transplant patients for up to 15 years. Ten years after the transplant, 79% of patients who received a kidney from a donor without a heartbeat were still alive. In comparison, 77% of the patients who received an organ from a donor with a heartbeat were living.

Because some have believed that organs deprived of oxygen would not last as long as those still being oxygenated by a beating heart, doctors try to wait for organs from a 'brain-dead' donor whose heart continues to beat. An article in The New Yorker (August 13, 2001) by Gary Greenberg points out the difficulties and the ethical questions of needing "a living body and a dead donor," He explains that the concept of brain death arose as doctors perfected organ transplant techniques in the 1960s. A Harvard committee composed of ten physicians, a lawyer, and a historian offered a new definition of death in 1968: "Responsible medical opinion is ready to adopt new criteria for pronouncing death to have occurred in an individual sustaining irreversible coma as a result of permanent brain damage." A Presidential Commission, appointed in 1980, recommended that "doctors be given the power to declare people dead based on the neurological criteria suggested by the Harvard committee." Some physicians are questioning the co ncept of brain death as an "artificial distinction."

Relying on organs from brain-dead people has led to a long waiting list for transplant organs. An article by Laura Meckler (April 23. 2002). reprinted from AP in The Hepatitis Education Project Newsletter, says that the number of transplant organs from healthy, living donors has jumped over the last two years to a record high of 6,485 in 2001. Instead of waiting 5 or 6 years for a kidney or piece of liver from another source, patients are accepting donations from family members and friends. Some patients have sought organ transplants in China or Taiwan where greater organ availability makes for a booming business. These countries are known to use organs from executed prisoners. In an article for The Seattle Times, Craig S. Smith reports: "The US transplantation society says decisions to donate organs must be made freely and without coercion or exploitation of any sort." The society considers it morally wrong to take organs from prisoners.

The Zurich study, which was published in the New England Journal of Medicine, followed kidney transplant patients. Ongoing research indicates that liver, pancreas, and lung taken from donors shortly after the heart stops will also be effective. Experts estimate that using organs from donors whose hearts have stopped will increase the number of available kidneys up to 30% in the US.

Associated Press. Now hope for organ shortage. [2002 July 25] The Hepatitis Education Project Newsletter 2002 August

Meckler. Laura. Living organ donors outpace dead. [Associated Press 2002 April 231 The Hepatitis Education Project Newsletter 2002 August.

Greenberg, Gary. As Good as Dead. The New Yorker 2001 August 13; pp 36-41

Smith, Craig S. Chinese organs present ethical dilemma in US. The Seattle Times 2001 November 11; A23

COPYRIGHT 2002 The Townsend Letter Group
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