Man presumed dead recovers during surgery to remove his organs for donation

Jun 11 2008

The revelation that a man whose heart had stopped beating, woke up just as surgeons were about to remove his organs for donation, is disconcerting to say the least.

According to reports in the French media, after failing to resuscitate a 45-year old man thought to have suffered a massive heart attack, transplant surgeons were called in to remove his organs.

Due to a series of complex circumstances, doctors had apparently continued providing heart massage for an hour and a half while they waited for the surgeons to arrive - however when the surgeons began operating the man began to breathe, his pupils became responsive and he showed a reaction to a pain test.

According to a report by the Paris university hospital's ethics committee the patient is now up and about and able to walk and talk; initially there were apparently some serious complications and it is unclear whether the man is aware of how close he came to losing his major organs.

The Paris hospital where the man was treated is one of only nine in France that are permitted to perform organ transplants on patients in cardiac arrest, in very specific conditions.

The pilot programme, the Non-Heart-Beating Organ donation (NHBOD) was launched in 2007 and involves retrieving organs when the heart stops, rather than when a patient is declared brain dead.

The hospital is involved in one of nine the pilot programmes for NHBOD which aims to help reduce the number of people waiting for a transplant by making it possible to take organs from new categories of patients.

The pilot programme has reportedly already made available an extra 60 organs.

The incident has highlighted the ethical problems doctors face in deciding when a donor is in fact dead and emergency staff at the hospital have reportedly witnessed other events where a person considered to be dead survived after prolonged re-animation and they say according to guidelines such patients would probably have been considered deceased.

The incident is guaranteed to fuel the public debate over NHBOD which has only been legal in France since last year.

In Australia several tests are carried out by two appropriately qualified senior doctors to establish whether brain death has occurred before organs can be removed.

In Australia as in France and the UK thousands of patients are on organ transplant waiting lists but France has an 'opt-out system' whereby everyone gives their "presumed consent" to having their organs removed after death, unless either they have refused permission or their family objects.

In Australia and the UK an 'opt in' system exists where people carry a donor card or signing the Organ Donor Register - the UK is however currently considering an opt-out system.

A committee, made up of medical professionals involved in the revival of heart attack patients as well as organ transplants, says such cases are completely exceptional.