When Does Life Stop? A New Way of Harvesting Organs Divides Doctors.

A new method for retrieving hearts from organ donors has ignited a debate over the surprisingly blurry line between life and death in a hospital — and whether there is any possibility that donors might still experience some trace of consciousness or pain as their organs are harvested.

The new method has divided major hospitals in New York City and beyond. It has been championed by NYU Langone Health in Manhattan, which says it became the first hospital in the United States in 2020 to try the new method. But NewYork-Presbyterian Hospital, which has the city’s largest organ transplant program, has rejected the technique after an ethics committee there examined the issue.

If adopted more widely, the method will significantly increase the number of hearts available for transplantation, saving lives.

The reason is that most heart donors currently come from a small category of deaths: donors who have been declared brain dead often after a traumatic incident like a car accident. But they remain on life support — their heart beats, and their blood circulates, bringing oxygen to their organs — until a transplant team recovers their organs.

The new technique, transplant surgeons say, significantly expands the potential pool to patients who are comatose but not brain dead, and whose families have withdrawn life support because there is little chance of recovery. After these patients’ hearts stop, they are declared dead. But hearts are almost never recovered from these donors because they are often damaged by oxygen depletion during the dying process.

Surgeons have discovered that returning blood flow to the heart restores it to a remarkable degree, leaving it suitable for transplant.