University of Nebraska Medical Center performs organ harvesting from living donors, resulting in their death

OMAHA, Ne. – Physicians at the University of Nebraska Medical Center appear to be skirting the laws governing the harvesting of human organs for transplant. 

Using a methodology known as “normothermic regional perfusion with controlled donation after circulatory death” (NRP-cDCD), surgeons remove organs from individuals who are not yet clinically dead. The protocol for the ethically questionable surgery was published by UNMC.. 

The patient is removed from life support, and once the heart has stopped – circulatory death – the surgeons wait two to three minutes to see if it restarts on its own. If it does not, they sever blood flow to the brain before artificially reanimating the circulatory system with an external pump.

The resumption of blood circulation restarts the beating of the heart. The brain must be shut off from its blood supply to ensure it doesn’t resume operation along with the other organs.

The purpose is to preserve the viability of the body’s organs to as close to living form as possible.

While some in the medical industry may see this as a clever means of sidestepping the legal guards around organ harvesting for transplants, many medical professionals are extremely uncomfortable with this process, pointing to routine instances of resuscitation long after the two-to-three-minute waiting time observed by the UNMC harvesters.

“Dr. Ari Joffe, a clinical professor of pediatrics and critical care at the University of Alberta, has found at least 12 patients whose hearts restarted without any medical intervention after as much as 10 minutes of cardiac arrest, and some of these patients made a complete recovery,” writes Dr. Heidi Klessig, a frequent writer and speaker about organ donation.

“In 2020, the heart of a young woman who had been declared dead by circulatory criteria was noted to have restarted during the removal of her kidneys, even as she began to gasp for breath. The coroner declared her ‘second’ death a homicide.”

As Klessig notes, in 1981 the Uniform Declaration of Death Act (UDDA) became law, establishing the parameters by which an individual may be considered dead. Under it, a person may be declared legally dead after the “irreversible cessation of circulatory and respiratory functions, or the irreversible cessation of all functions of the brain, including the brainstem.”

Since UNMC’s procedure restarts the circulatory process within minutes of declared death, many argue this process, by definition, proves the circulatory and respiratory functions have not “irreversibly” ceased. UNMC physicians justify this apparent contravention of the UDDA by falling back on the “brain death” exemption. 

As Klessig points out, “the American College of Physicians (ACP) recommended in 2021 that the practice of NRP-cDCD be paused, as ‘the burden of proof regarding the ethical and legal propriety of this practice has not been met.’”

Some nations, such as Australia, have banned NRP-cDCD altogether.  

Despite these clear ethical concerns, this type of organ-harvesting is continuing and expanding in the United States.

Dr. Matthew DeCamp, a bioethicist at the University of Colorado, wrote in the journal Chest:

“Restarting circulation reverses what was just declared to be the irreversible cessation of circulatory and respiratory function. It is no defense to suggest that the patient was already dead when the action negates the conditions upon which that determination was made.”

The dead donor rule states that organ donors cannot be killed in order to obtain their organs, and organ procurement cannot cause death. Bringing about brain death by removing its blood supply within 60-90 seconds of the heart stopping appears a clear violation of the rule.

The “non resuscitation talk” is now common in American hospitals. UNMC in particular stresses the violence to the body that occurs with CPR, offering grisly details to the patient and their families, such as ribs breaking and other damage due to CPR.

Many physicians argue this rehearsed pitch actually reveals the “talk” to be a coordinated policy, rather than helpful advice from a concerned nurse or physician. 

As Dr. Klessig concludes:

“Transplant physicians who perform NRP-cDCD are playing fast and loose with both the spirit and letter of the law as spelled out by the UDDA. Because these patients are still capable of being resuscitated, they are not yet dead, and they are being actively harmed by physicians in pursuit of their organs.  

“Because these donors are not brain-dead, do they have some level of awareness as they are taken to have their brain circulation cross-clamped?  How many families would give their loved ones over to transplant teams if they knew the grisly reality taking place behind the operating room doors?”