By taking a heart from a dying infant within 75 seconds of the heart stopping, the chances of a successful transplant to another baby are greatly increased, according to a study in today's New England Journal of Medicine that is raising ethical questions about the definition of death.
The study examined the cases of three dying newborns whose hearts were taken within 75 seconds of cardiac death and given to three other infants.
"As a result of their investigational protocol, three babies are now alive; had the procedures not been performed, it is virtually certain that all six babies would be dead," the journal's executive editor Dr. Gregory Curfman and others wrote in one of several commentaries accompanying the study.
Organ harvesting after cardiac death -- rather than waiting for brain death -- is much more common in the US than in Canada. The standard until now, however, has been to wait until five minutes after cardiac death before removing organs.
The journal notes, however, that the longer a heart remains in the body, deprived of oxygen, the lower the chances of a successful transplant.
Dr. Kerry Bowman of the University of Toronto's Joint Centre for Bioethics told the CBC the study raises issues about the definition of death and how soon is too soon for doctors to start harvesting organs.
"I think the pull and the need for organs is so strong that it could easily encourage critical care physicians to consider the declaration of death potentially sooner than they normally would," said Bowman, who is not opposed to donating after cardiac death.
Robert Truog, professor of medical ethics at Harvard University and author of one of the commentaries, told Bloomberg, "The worrisome thing that people might take away from the study is that doctors are doing something unethical in order to increase the number of organs for transplantation. That would be the wrong conclusion.''
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