- Organ procurement from an individual in whom all brain function has ceased but normal cardiac pump activity continues is “heart-beating organ donation.”
- Organ procurement after cessation of cardiac pump activity is called “non-heart-beating organ donation (NHBOD).”
- This is an emerging and important source of transplant donors.
Organ procurement is only permitted when the donor is already dead and the act of organ recovery cannot have been the immediate act to cause that death.
The main difference between conventional beating heart organ donation and non-beating heart organ donation is the criteria for death.
- The diagnosis of death is based on brainstem criteria in beating heart donors, whereas it is based on cardiac criteria in the non-beating heart donor.
- The risk for warm ischemia is higher in the non-beating heart donor organs.
- Although the non-beating heart organ transplantation has been successful in kidney transplants, where the success rates from the beating and non-beating donors are similar, it is not so for other organ transplants, which have lower success rates when transplanted from non-beating heart donors.
- Liver transplantation from non-heart beating donors (editorial). BMJ 2006;332:376-377 (18 February), doi: 10.1136/bmj.332.7538.376
- Truog RD. Consent for organ donation — balancing conflicting ethical obligations. New Engl J Med 2008;358(12):1209-1211.
- Rubenstein A, et al. The definition of death and the ethics of organ procurement from the deceased. The President’s Council on Bioethics. http://www.bioethics.gov/background/rubenstein.html
- Rady MY, et al. Organ procurement after cardiocirculatory death: a critical analysis. J Intensive Care Med 2008;23:303-12