'Dead' man wakes as transplant surgeons prepare to remove his organs
Pastor Dale Morgan
'Dead' man wakes as transplant surgeons prepare to remove his organs*
By Henry Samuel in Paris
Last Updated: 9:35PM BST 10/06/2008
A man whose heart had stopped beating woke up just as surgeons were
about to remove his organs for donation, it was disclosed yesterday.
Doctors in Paris earlier this year called in transplant surgeons after
failing to resuscitate a 45-year old man believed to have suffered a
massive heart attack in the French capital.
According to a report by the Paris university hospital's ethics
committee - seen by Le Monde newspaper - doctors continued providing a
heart massage for an hour and a half while they waited for the surgeons
to arrive.
When the surgeons began operating on the man to remove his organs, he
began to breathe, his pupils became responsive and he reacted to a pain
test.
"After a few weeks chequered with serious complications, the patient is
now walking and talking," said the report. It is not known whether the
man is aware of how close he was to losing his organs.
The incident highlights the ethical problems doctors face in deciding
when a donor is really dead.
Emergency service staff interviewed in the report said they knew of
other situations where "a person who everyone was convinced was dead
survived after prolonged re-animation moves well beyond usual timeframes
or even those considered reasonable."
They pointed out that if they had followed the rules to the letter, such
patients "would probably have been considered deceased."
In particular, the case is likely to ignite public debate over so-called
controlled non-heart-beating organ donation (NHBOD) – retrieving organs
when the heart stops, which has only been legal in France since last
year. Before then a patient had to be declared brain dead before
transplant could occur. NHBOD is legal in the UK.
"All specialised medical literature on the subjects allows one to
conclude that a person who has suffered cardiac arrest and has had
proper heart massage for over 30 minutes is, for all purposes, brain
dead," said Professor Alain Tenaillon, in charge of organ transplants at
France's biomedical agency. "But one must acknowledge that exceptions do
exist ... there are no hard and fast rules on best practice," he told Le
Monde.
Some 13,000 people are awaiting organ donations in France, a far higher
number than in Britain, with 7,700 awaiting organs, despite France's a
so-called opt-out system. This means everyone gives their "presumed
consent" to having their organs removed after death unless either they
have refused permission or if their family objects.
In the UK, people "opt in" to the donation system by carrying a donor
card or signing the Organ Donor Register. A Department of Health task
force is currently looking into the opt-out system.