New Ways to Attract Organ Donors
Panel Calls for Revised CPR Methods to Increase Organ Donations
May 2, 2006 -- A government panel called on American hospitals and emergency
medical responders to revamp their resuscitation procedures as a way to
preserve more organs for transplants.
The recommendation comes amid a widening shortage of transplantable organs
that many experts have branded a crisis. Demand for transplantable organs has
far exceeded the rate of transplant donations over the last decade.
Just over 28,000 organs were donated last year, far from the number needed
to treat the more than 98,000 people waiting on lists for transplants as of
Tuesday, according to the United Network for Organ Sharing.
Longer life expectancy means that more Americans survive long enough to see
their organs give out. Skyrocketing rates of obesity and diabetes put far more people than before at risk
for organ failure.
New CPR Methods
The shortage has left policy makers searching for ways to boost donations
among a largely reluctant American public.
Experts from the Institute of Medicine (IOM) said Tuesday that emergency
responders should change resuscitation procedures in an effort to preserve the
organs of accident victims and others who die outside of hospitals. The
recommendations essentially call on responders to regularly continue
cardiopulmonary resuscitation (CPR) on patients who are not revivable to keep
blood flowing to kidneys, livers, and other organs so that they may be better
candidates for possible organ donation.
Doing so could give transplant surgeons access to a pool of up to 16,000
people who die with organs suitable for transplant, the panel concluded.
"Those really represent an untapped resource," James F. Childress,
PhD, the panel's chairman, tells WebMD.
Financial Incentives for Organ Donations
The report also calls for federal authorities to fund more research on
methods for encouraging altruistic donations and to help coordinate a growing
number of state donor registries on a national scale.
But the committee avoided several bolder -- and more controversial --
proposals that some experts consider necessary to spur organ donations. They
include calls to introduce a system of "assumed consent" -- essentially
authorizing surgeons to take organs from deceased patients whose wishes are
unknown and whose families are not available to make decisions.
Some ethicists have also called for the gradual phase-in of financial
rewards for donations, essentially beginning a system of paying for organs.
Such a system has been credited with eliminating the waiting list for kidneys
"We're not going to get many more organs by making small adjustments to
the current system," said Robert M. Veatch, a professor of medical ethics
at Georgetown University who has called for experimentation with
Veatch and others have backed expanding organ donor criteria to include
patients in permanent vegetative states and permanent comas if they are
irreversibly unconscious. It would be a departure from current practices
requiring such patients to be first removed from life support, often damaging
organs in the intervening time while the heart stops pumping blood.
"It would add substantial numbers of persons who are dead with viable
organs," said Veatch.
The United Network for Organ Sharing (UNOS) strongly opposes any financial
or other incentives for organ donations. UNOS officials did not respond to
requests for comment Tuesday, but Francis Delmonico, the network's president,
told a White House bioethics panel two weeks ago that his group would
"staunchly" oppose incentives.
The IOM panel also recommended against so-called "mandated choice"
laws that would compel people to affirmatively choose on tax returns or
driver's license applications whether or not they wish to donate.