Lung Transplant Using Nonbeating Heart Donor Works
"What that means is, if you're sitting in an ICU somewhere and a patient dies, you have to take some steps on the off chance they might be a donor," Elliott tells WebMD. "But for many people, that's a huge ethical step, because it suggests that you have imposed the moral obligation to go ahead and donate."
To prevent such ethical fires from flaring up in the first place, Steen and colleagues took the extraordinary step of inviting public comment on their proposed technique in a wide-scale information campaign on television and radio and in major newspapers. They also consulted with physicians, nurses, hospital chaplains, and judges. "From this consultation, we learned that any type of surgery on a dead body within 1 hour of death was ethically unsound, but that if topical cooling of the lungs could be accomplished without leaving scars, then the planned procedure ought to be acceptable," the authors write.
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.