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| (left) Associate Professor Mario C. Deng of Columbia University College of Physicians and Surgeons, New York Mario Deng led the team that discovered that many heart transplant recipients don't survive longer than those who missed out on a transplant. In the study, Effect of receiving a heart transplant: Analysis of a national cohort entered on to a waiting list, stratified by heart failure severity, the survival outcomes for all 889 adult patients listed for a first heart transplant in Germany in 1997 were measured. Patients needing heart transplants were listed into three categories - those with a high, medium or low risk of dying while awaiting surgery. Transplanted hearts go to high risk patients because of their obvious illness, but also to medium and low risk patients, with slightly less desperate heart problems, because they have a generally better chance of surviving the surgery, anti-rejection drugs, cancer tumours and AIDS-like diseases that follow. Mario Deng's team discovered that while, on average, the highest risk patients could expect a higher life expectancy from a transplant, those in the other two categories actually lived longer if they missed out. Associate Professor Deng's study is available on the British Medical Journal site at www.bmj.com/cgi/content/full/321/7260/540 ________________________________________________ (left) Associate Professor Michael Potts, one of the editors of Beyond Brain Death and Head of the Philosophy and Religion Department of Methodist College, Fayetteville, N.C., U.S.A. "A number of thinkers from diverse disciplines such as medicine, philosophy, and theology, are now openly questioning brain-based criteria for declaring death. That this issue is important is obvious; if brain dead patients are not dead, then harvesting unpaired vital organs from these individuals directly causes their deaths. from Journal of Medicine and Philosophy Read Michael Potts latest letter in British Medical Journal - Law, Death and Reality ______________________________________________________ (left) Dr David Hill, Emeritus Consultant Anaesthetist, Cambridgeshire, U.K.; Harvest theatre nurses also express doubt about the health status of the donor. Dr David Hill, also an anaesthetist, checked operating theatre registers at Addenbrooke Hospital in the United Kingdom and discovered that nurses recorded the time of death at the end of harvesting as if the donor had come in to the harvest room alive. 22 On declaring brain death Dr Hill says, "…doctors who are sympathetic to this form of death are required and consequently others, such as myself, who would not certify death on the basis of such tests, are not asked. It is doubtful whether this situation would pass any serious scrutiny for being truly independent of the transplant team." ______________________________________________________ (left) Dr David Wainwright Evans, Consulting Cardiologist, Papworth Hospital, UK, Fellow Commoner, Queens College, Cambridge, United Kingdom Treatments for brain injury and maintaining organs for harvest are often contradictory. The protocol for the brain death test requires that no brain protective drugs like barbiturates are present. Therefore the potential donor may get inferior healing treatment to the organ keeper. Dr Evans says, "Barbiturates are protective – but the protocols envisage that such therapeutic measures will have been abandoned ere (before) testing for brain stem death is undertaken. That was the case in the early days. There was much discussion about how long one should wait to be sure that all such drug influence had cleared. Clearance can be very slow in some cases. Nowadays there is such haste to certify death for transplant purposes that barbiturate therapy is unlikely to be tried..." Read Dr Evan’s Brain Death is Not Death Commentary on the Truog & Robinson article from Crit Care Med 2003; 31: 2391-96 ______________________________________________________ (left) Duane Horton OrganKeeper.com is built and operated by Duane Horton who wants to increase transplanting by making it more attractive to donate organs. He says prospective donors should get priority, if they need an organ, over non-donors. Donors should be able to determine what types of people will or won't get their organs and that donor estates should be paid for the organs since everyone else in the industry appears to benefit. To attain these changes Duane says organ donors should refuse to donate until governments improve the rights and conditions for those donating their body parts. Duane Horton lives with his wife and two children in Rhode Island, United States, where he works as an engineer. Back To Main Page |
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