Plan would add to pool of potential donors

An IOM report calls for more education on donation and says that to reduce transplant demand, people should take better care of themselves.

By Susan J. Landers, AMNews staff. May 22/29, 2006.

Washington -- A large, relatively untapped store of transplantable organs from deceased donors exists that could help shrink the gap between the tremendous need and the scant supply, according to a new Institute of Medicine report. These organs reside in the bodies of the many thousands of people who die each year of cardiac arrest.

Currently, most people in the United States who are pronounced dead according to circulatory criteria are not considered potential organ donors. Instead, organs from deceased donors overwhelmingly come from people who have died in hospitals where they were pronounced dead according to neurological criteria.

But both declarations of death should open the door to the possibility of donation, said panelists who drafted the report, "Organ Donation: Opportunities for Action."

Among recommendations from this panel of physicians, nurses, lawyers and ethicists was one urging that federal agencies, hospitals, transplant centers and professional societies implement initiatives to increase donation rates after circulatory determination of death, or DCDD.

At least 22,000 people each year who die of cardiac arrest are potential donors, according to the report, and the effective use of this resource could greatly boost the supply of organs. Last year, 7,593 deceased donors, most of whom were declared brain dead, contributed 21,215 organs to individuals on waiting lists.

"It's ironic that we've used such a structured approach to transplantation to include only those who die of brain death," said Lewis Goldfrank, MD, professor and chair of emergency medicine at New York University School of Medicine, and a panelist. "Most people die of cardiac failure."