The grieving family was gently reminded by medical professionals that their loved one wanted to donate his organs, and they left the hospital room. To do so, death must be declared. After a mandated pause, surgeons retrieve life-giving organs from people ranked in order of need on the transplant waiting list.
What happens next depends on a series of branching events. First, how death is determined, then how organs are evaluated and cared for during transit between donor and recipient. A classic image is of a medical worker holding an igloo cooler as he jumps out of a helicopter. But new methods employed in the past five years, including both warm and cold perfusion techniques that keep fluid flowing through the organ to halt the organ’s time to decline, have made that image obsolete.
Advances in technology and ethically complex changes in determining when and how organ removal can begin are transforming the field of organ donation. Various forms of new perfusion approaches, sold by different companies and developed by different hospitals, can shave days or months off waiting lists and make more donor organs available. Important fluids and nutrients can be injected into the organ before and after resection to minimize damage before transplantation. Inflating the lungs, adjusted by refrigeration to accommodate changes in air pressure on a plane, could extend the organ’s usefulness for many hours. Surgery can be scheduled while the organ is stable in the perfusion box and there is no need to discard organs that decline within a limited time.
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