Canadian MDs to restart hearts of the recently dead as new source of donor hearts
Doctors in Canada are preparing to restart the hearts of the recently declared dead, a move experts say will lead to a desperately needed new source of donor hearts.
But that raises an ethically fraught question: How can you be dead if your heart is still beating?
The technique involves taking hearts from organ donors whose hearts have stopped, and restarting them in one of two ways: outside the body, or inside the body of the dead donor.
The plan is to proceed cautiously at first in Canada, and revive hearts inside a portable device, a “heart-in-a-box,” perfusion machine that looks much like a miniature ICU. Blood collected from the donor is pumped through an oxygenator and into the heart. The disembodied organ can be kept alive inside the sterile rig, beating and “breathing,” somewhat spookily, for up to 12 hours, before it’s transplanted. It’s an approach already being used in Australia and the U.K.
The British doctors, however, have gone further: In a carefully choreographed sequence, after life support is withdrawn from an organ donor, after the heart stops beating and doctors wait the obligatory five minutes before declaring death — convinced there is no pulse, no heartbeat, no chance of the heart spontaneously restarting on its own — the body is taken to the operating room. Surgeons cut into the sternum, clamp the main arteries supplying blood to the brain and connect the body to a machine that takes over the work of the heart and the lungs. The machine is called ECMO, or extracorporeal membrane oxygenation. It was famously used to save lives in the SARS outbreak in 2003.
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