Lung Transplant Using Nonbeating Heart Donor Works
The researchers had previously demonstrated that their technique could be effective in animals. For their first human case, they obtained donor consent from the family of a 54-year-old man who suffered a heart attack in the hospital and could not be revived despite 50 minutes of attempted resuscitation. Ten minutes after the patient's death, the doctors administered heparin to his body; this drug prevents blood clotting that could irreparably damage the lungs before they could be removed.
With the family's permission, the researchers started cooling the lungs by pumping a special solution into the chest cavity of the man's body 65 minutes after death. The family was then given time to be alone with the body; afterwards, the organ donation process began.
Once the donated lungs were found to be suitable for transplant, the right lung was implanted into the recipient, a 54-year-old woman with emphysema. There were no major complications to the surgery, and the lung showed "excellent" function within five minutes of the start of blood flow and breathing. The patient got out of bed the next day and at five months after surgery had good lung function.
Elliott tells WebMD that a potential pitfall of the technique the researchers describe is that the donor team and the recipient team, which have obviously different agendas, could overlap in their assigned tasks, "which in most transplant practices is seen as something which is bad, because you interpose between you and the family a team whose commitment is to the recipient and not to the donor. The more you overlap those two roles, the greater the risk that pressure is put on a family to donate which is ethically unacceptable."
The public outreach efforts used by the Swedish researchers to establish ethical standards are not entirely new, however, says a medical ethicist who commented on the study for WebMD.
In fact, Robert Veatch, PhD, a professor of medical ethics at the Kennedy Institute of Ethics at Georgetown University, tells WebMD that through the effective lobbying of some members of the medical community, the D.C. city council passed an ordinance that allows surgeons to cool a body -- but not obtain organs -- in cases where patients have died but their status as potential organ donors with the family's consent is unknown.
Despite Elliot's reservation about Steen's procedure, he says that this report "should encourage a wider ethical debate about the potential for the use of nonbeating heart donors. For transplantation to become a successful form of therapy, the supply of donors must be increased."