Hospital organ transplant procedures too lengthy

Hospitals may want to reconsider their methods when it comes to collecting organs for transplantation purposes, as a study published this week in the journal Neurology finds that current practices tend to take too long, rendering those organs useless. 

Current protocol at many hospitals involves conducting two medical exams on dying organ donors, separated by at least six hours, to keep those patients from being declared "hopeless" too quickly, according to the Los Angeles Times. Researchers, however, discovered the median time span between the first and second exams to be 18.5 hours. With the expanded time frame came hesitance: family consent for donation dropped from 57 to 45 percent, while refusals rose from 23 to 36 percent. What's more, 12 percent of patients wound up in cardiac arrest due to the long gap, meaning their organs couldn't be used. 

The long delays also cost hospitals in the New York region, where the study was conducted, upward of $1 million annually in intensive-care-unit costs. Overall, the cases of 1,229 adults and 82 children pronounced brain dead at 100 hospitals between June 2007 and December 2009 were reviewed. 

"A single brain death examination to determine brain death for patients older than 1 year should suffice," the study's authors conclude. "In practice, observation time to a second neurologic examination was three times longer than the proposed guideline and associated with substantial intensive care unit costs and loss of viable organs." 

A second study, published this week in the Journal of the American Medical Association, concluded that a strategy of leaving lungs slightly inflated between breaths while lowering a respirator's flow of air into those lungs doubled the proportion of lungs able to be used in transplants, according to the Times

For more information:
- check out the Los Angeles Times piece
- here's the Neurology study's abstract
- read the JAMA abstract

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