New organ donation technique challenges line between life and death

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In 2021, Navy officer Tony Donatelli felt a pain in his legs that got worse.

He was diagnosed with AL amyloidosis, a rare disease where abnormal proteins gather in the organs. At 40 years old, he went from being a fit, active-duty Navy officer to sometimes not being able to walk around a hospital room five times.

“I was decomposing,” he said.  “I was losing muscle. I was getting weaker.”

Donatelli needed a heart, liver, and kidney transplant to live, and he needed all three organs at the same time.

People who need organ donations sometimes wait for months or years. Some even die while waiting for an organ transplant.

But, Donatelli got those three organs, thanks to a donor and a new technique that can recover more organs from each donor, and organs that are less likely to fail.

After Tony Donatelli was diagnosed with AL amyloidosis, he needed a heart, liver, and kidney transplant to live. A new and controversial technique to harvest more organs from a donor saved Donatelli’s life. (Courtesy of Tony Donatelli)

However, the new procedure is controversial, even among doctors. The American College of Physicians, the second largest professional group for doctors in the U.S. declared this procedure unethical, and said it should not be allowed in the U.S, because, “nature is not taking its course, but rather medicine is intervening to ensure death.”

Right now, most organ donations come from people whom doctors declare brain dead, meaning they have no brain function. A surgical team takes a donor to an operating room, opens up their chest, and takes the organs out.

Later, doctors also started to collect organs from people who died because their hearts stopped. Doctors declare that someone is dead, wait a while to confirm that the person’s heart will not start again on its own. Then, they could recover lungs, livers, and kidneys, but not hearts.

Doctors used to think that technique didn’t work on hearts, because if a heart had stopped without oxygen for too long, it would be irreversibly damaged.

But the new procedure that saved Tony Donatelli’s life — NRP, or normothermic regional perfusion — changes things.

  • December 18, 2023
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