Organ donation follows careful protocolAfter reading the...

SATURDAY MAIL BOX

April 26, 1997

Organ donation follows careful protocol

After reading the April 13 story, "Prosecutor says hospital seeks to hasten death: In Cleveland, organs were sought for transplant," I felt the citizens in Maryland and the hospitals that we serve should know the facts related to donation.

Maryland law is very clear -- patients must be declared dead before any organs or tissues are recovered.

Death may be the result of a cardiac arrest or an irreversible brain or brain stem injury. Death is pronounced by the physician caring for the patient, according to Maryland law and hospital policy.

Prior to the existence of brain-death laws, all organs were recovered after cardiac death had occurred.

The number of organs suitable for transplant and the long-term outcome of those patients transplanted were significantly reduced because the organs were without the necessary supply of circulating blood and oxygen.

Since the passage of brain-death laws in Maryland, we have opted to recover organs only from brain-dead patients -- simply because the long-term results are much better.

Maryland law also states that we must offer the right to consider donation to families of all potential donors. Therefore, it is the philosophy and practice of the Transplant Resource Center of Maryland to evaluate the full potential for donation in all patients referred to the TRC and to offer the option of donation to all families where the potential exists.

Recovering organs after cardiac death, while clearly less desirable from a transplant perspective, is really a benefit for the donor's family.

Many Maryland families want their loved ones to donate organs, but because they died from a cardiac arrest as opposed to brain arrest, we have been unable to fulfill their wishes. Organ recovery after cardiac death would enable the TRC and the patient's family to honor the patient's wishes (as designated on his or her driver's license, advance directives or through family discussion).

The TRC has not yet recovered organs from non-heartbeating donors. However, a newly developed protocol is available and later this year will be offered to donors' families. Key points from the protocol are:

The non-heartbeating donor protocol will be initiated only in those cases where the patient's family has consented to donation but the patient does not meet brain-death criteria and the family has chosen to withdraw mechanical and medical support.

The TRC does not endorse discussion of donation until after the patient's family understands and accepts the patient's terminal condition and has decided to discontinue support measures.

The TRC's policy clearly states that no donor-related procedures will be performed prior to death. This includes no administration of any drugs that are intended to preserve organ functions.

All patients must be pronounced dead by the treating or attending physician according to standard medical practice, state laws and established hospital policies.

No member of the TRC or the organ recovery team will be involved with the declaration of death process. Nor will any transplant physician or transplant surgeon be involved with any portion of the informed consent process.

The TRC, its staff and board take very seriously the public's trust of our services and our mission. The 1,700 patients on Maryland's transplant waiting and their families depend on us to do the right thing every day.

Julie Mull Strange

Baltimore

The writer is president and chief executive officer of the Transplant Resource Center of Maryland.

Pfaff column didn't get the truth right

William Pfaff's April 15 column, "Unrestrained by the U.S., Netanyahu can press on to an apartheid Israel," was very biased and contained many misrepresentations.

Most glaring was his statement that "Israel's official position is that Jerusalem is the unique and undivided capital of the Jewish state, but in the past, there has been some room for accommodation of the Palestinian demand that it be theirs, too.".

Every Israeli administration, whether Labor or Likud, and the overwhelming majority of the Israeli population agrees that Jerusalem must remain the undivided capital of Israel.

Another misleading statement implied that Christians and Muslims currently do not have religious freedom in Israel and that "some kind of international status or protection" is needed. The truth is that Christians and Muslims enjoy more religious freedom in Israel than non-Orthodox Jews.

Apparently, Mr. Pfaff chooses to forget that from 1948 to 1967 -- the 19 years that the West Bank and the Old City of Jerusalem were under Jordanian control -- Jews were not allowed to visit Jewish holy sites, most of which were desecrated and destroyed by the Arabs during that period.

That was apartheid.

Bernard Siegel

Baltimore

Senior center doesn't belong in Cheswolde

This is in response to the April 20 letter from Carl S. Hyman, president of the Cheswolde Neighborhood Association, to which we belong. He supports a five-story assisted living facility in our community.

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