ST. LOUIS — To allay fears that surgeons might try to retrieve the organs of dying patients prematurely, the federal contractor that oversees organ transplantation approved standards Friday to protect the growing number of donors who have no hope of recovery but who are not officially brain-dead.
The board of the United Network for Organ Sharing formalized its guidelines as authorities in San Luis Obispo County investigate whether a transplant surgeon ordered excessive doses of medication last year in an attempt to hasten the death of such a potential donor, a 26-year-old developmentally disabled man.
The county district attorney's office, which last week received the case from police, has not decided whether to file criminal charges against the San Francisco surgeon, Dr. Hootan Roozrokh, officials said.
"Clearly nobody wants to have the instance in San Luis Obispo repeated," said Dr. Sue V. McDiarmid, president of the United Network for Organ Sharing and a pediatric transplant physician at UCLA Medical Center. "It's not in the interest of anybody."
McDiarmid said the network began working on rules in 2004 to standardize practices for what is known as "donation after cardiac death" -- the type of organ retrieval at issue in San Luis Obispo. That case underscores the urgency of the work, she said.
In donation after cardiac death, donors have suffered a devastating brain injury and require ventilators to breathe but still have minimal brain function. Such retrieval has become more common in recent years as doctors have sought to expand the donor pool beyond the limited number of people who are brain-dead.
In such cases, patients are removed from life support with families' consent. Generally, their hearts stop within minutes and they are declared dead. Their organs are then harvested. (In the San Luis Obispo case, the donor's heart did not stop for several hours, which made his organs no longer viable for transplantation.)
Last year, there were 647 such donors nationwide, compared with 189 four years earlier. They account for about 8% of organ donors.
At a meeting in St. Louis on Friday, the United Network for Organ Sharing board said that all transplant hospitals must have policies preventing organ recovery teams from taking part in the care of a potential donor before a nontransplant doctor declares the patient dead. Members of the team are not even allowed to be in the room when life support is withdrawn, according to the standards.
