Organ retrieval reforms ordered after some donors showed 'signs of life'
The federally chartered nonprofit groups known as organ procurement organizations (OPOs) that coordinate the donation process will face decertification if they fail to follow protocols that regulate when an organ can be extracted from a dead patient, according to a release from HHS.
The announcement, which comes ahead of a House hearing Tuesday morning on safety breaches in the organ donation system, stems from an HHS investigation into reports that workers for OPOs pressured doctors to start procuring kidneys, livers and other organs from patients even as they showed signs of life.
It follows a report by the New York Times Sunday about such patients, including one who was presumed to be dead but whose heart was discovered to be beating after a surgeon made an incision in her chest for procurement surgery.
'Our findings show that hospitals allowed the organ procurement process to begin when patients showed signs of life, and this is horrifying,' Kennedy said in a statement.
In a March report, HHS looked at 351 cases in which organ donation was authorized but not completed. It found 103 cases with 'concerning features, including 73 patients with neurological signs incompatible with organ donation,' according to Kennedy's statement. At least 28 patients may not have been deceased when organ procurement was initiated, the statement said.
HHS also said it found evidence of 'poor neurological assessments, lack of coordination with medical teams, questionable consent practices and misclassification of causes of death.'
Kennedy said OPOs will need to adopt a formal process allowing any staff member to halt a donation process if patient safety concerns arise. They also will need to review any failures to follow protocols — including a requirement to wait five minutes after a patient is dead before making an incision — and develop clear policies around who is and isn't eligible for organ donation.
The nation's supply of organs — which falls far short of demand — has been boosted in recent years by the practice of removing organs from patients who have experienced 'circulatory death.' Such patients may still show brain activity but doctors have determined they are near death and won't recover. With family consent, life support can be withdrawn and doctors then wait for the heart to stop beating.
Most organ donations are still from brain-dead patients, but OPOs in some cases have pressured doctors to move quickly in procuring organs in the short time frame required.
HHS launched its investigation after a House committee hearing in September, where the former employee of an OPO revealed that she, a surgeon and other workers refused to procure organs from a patient who was being prepared for surgery but was shaking his head and crying.
The procurement organization, Network for Hope, is responsible for coordinating organ donation in Kentucky and parts of Ohio and West Virginia. Its officials were not immediately available for comment.
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Dr. Sanjay Gupta 00:00:03 Welcome to Paging Dr. Gupta. As you know, this podcast is one of my favorite podcasts because the best health conversations that I've heard often start with simple, honest questions. And that's what we try and address here each week. Kyra's back with us. What do we have first? Kyra Dahring 00:00:23 So first up today, this listener has a question sparked by a recent Chasing Life episode. And honestly, it kind of has me thinking back to that conversation too. Take a listen. Listener Question 00:00:35 I am following up on your episode with Dr. Tim Spector and he talks about 30 vegetables. What would be those 30 vegetables? And are frozen vegetables just as good as fresh vegetables? I've heard that they're better, hold their nutrients, vitamins, etc. Thank you. I look forward to hearing a podcast answering these questions. Dr. Sanjay Gupta 00:01:01 This is a really good question, are frozen vegetables actually healthy, or are they just plan B when fresh isn't available? I'm going to tell you the answer to that, plus really dig into what Dr. Spector meant about 30 vegetables right after this quick break. Dr. Sanjay Gupta 00:01:20 Okay, let's start with the 30 vegetable part of this. Here is a quick refresher of that Chasing Life episode with Dr. Tim Spector... Dr. Tim Spector 00:01:29 What I'm trying to do is give myself the room so I can have 30 different plants during my week. And that's that diversity of plants, which I think is probably the most crucial rule for nutrition. Dr. Sanjay Gupta 00:01:42 'Okay, so what does that mean? First of all, it does not mean you need to eat 30 vegetables a week. What he's really saying is try to eat thirty different plant-based foods each week. That could include vegetables, yes, but also fruits, whole grains, nuts, seeds, legumes, herbs, even some spices. 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That's when they're most nutrient rich. They are then typically blanched, which means they are briefly dipped in hot water to stop spoilage, and then they are flash frozen. And that's what locks in most of their nutrients. Now it is true that some heat-sensitive nutrients like vitamin C, that may dip slightly during the blanching process. But overall, studies have shown frozen vegetables, frozen veggies, have nutrient levels that are very similar to fresh and sometimes even higher. Especially if that fresh produce has been sitting around for days. Now, another key point here, frozen veggies are actually really good at holding onto their nutrients. Fresh produce starts losing vitamins the moment they are picked and continues to lose them in transport and storage in your refrigerator. Frozen vegetables don't keep losing nutrients the way fresh ones do. So, frozen vegetables, they're a win. In so many ways, including cost and convenience and variety. They last longer. 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Dr. Sanjay Gupta 00:05:17 All right, Kyra, what do we have next? Kyra Dahring 00:05:19 Yes, we got this next question from a listener who is wondering about a health trend that some of us might have seen on social media. Here's what she asked. Listener Fran 00:05:28 Hi, my name is Fran and I'm 70 years old. I am calling in to find out about all the studies on pink Himalayan salt. There are people that drink Himalayan salt with lemon water in the morning and what it's good for. Dr. Sanjay Gupta 00:05:44 'Okay Fran, thank you so much for your question about pink Himalayan salt. It's definitely popular right now. I think we have some sitting in our own kitchen. Interestingly the salt primarily comes from a mine in Pakistan near but not in the Himalayas. The pink color comes from trace minerals like iron, calcium, potassium, and magnesium, which some people think makes it healthier than regular table salt. Just a side note by the way, sea salt also contains many of these same minerals. And sure, pink Himalayan salt tends to be less processed than table salt, which is refined, table salt is to remove impurities, they may contain anti-caking agents as well in table salt and oftentimes it's fortified with iodine, a micronutrient that is essential to human health and wellbeing. But here's the thing, those extra minerals that we're talking about in pink Himalayan salt, those minerals that are often at the root of a lot of these health claims. They're really only present in tiny trace amounts, too small to really have any health impact unless you're consuming unrealistic quantities and you shouldn't do that because it's salt and we eat too much salt already. Additionally, many of the minerals that are in pink Himalayan salt in those trace amounts are actually easily obtained from other healthy foods. Now, some of the health claims you may have heard about pink Himalyan salt, improves sleep, balances your body's pH, boosts energy. But the truth is, there's little scientific evidence to support those specific benefits. Now, to be fair, it'd be really hard to do a study like that, but there just isn't the scientific data to support these claims. Now, this idea about adding it to water. That is actually a trend people are doing. It's called sole, sole water. It's made by adding pink salt dissolved in water and often consumed with lemon. People say that it boosts energy, it detoxifies the body, but again, there's not solid science behind those claims. What is important to know again, is that most people already consume way more sodium than they need. So drinking sole water just adds even more sodium into your diet, which can actually have risks, high blood pressure, kidney issues. So bottom line, is pink Himalayan salt better than regular salt? Not really. It's a fine natural option if you prefer it, but it doesn't offer any proven meaningful health advantages, and it does tend to cost more. Plus, as I mentioned, it typically does not contain added iodine, which is really important to your health. So if you're using pink Himalayan salt exclusively, do make sure you're getting your iodine from foods like seafood or dairy or seaweed. In the end, whatever salt you choose, it is still salt. Moderation is key. Hope that helps, Fran! Dr. Sanjay Gupta 00:08:41 'And thanks to everyone who sent in questions, your curiosity, your stories, your voices, I love hearing it, and that's what brings this show to life. So keep it coming. If there's something health-related you've been wondering about, send it to us. We might answer it next week! Record a voice memo, email it to AskSanjay@ or give us a call, 470-396-0832 and leave a message. Thanks for listening. I'll be back next Tuesday.
