Latest news with #organ transplant
Yahoo
2 days ago
- Health
- Yahoo
US organ donation system faces scrutiny and changes after reports of disturbing near-misses
WASHINGTON (AP) — The U.S. is developing new safeguards for the organ transplant system after a government investigation found a Kentucky group continued preparations for organ donation by some patients who showed signs of life, officials told Congress Tuesday. While the organ removals were canceled, near misses that some lawmakers called horrifying should never happen. A House subcommittee asked how to repair trust in the transplant network for potential organ donors and families -- some of whom have opted out of donor registries after these cases were publicized. 'We have to get this right,' said Rep. Brett Guthrie, a Kentucky Republican who chairs the Energy and Commerce Committee and whose mother died waiting for a liver transplant. 'Hopefully people will walk away today knowing we need to address issues but still confident that they can give life,' Guthrie said, adding that he will remain a registered organ donor. The hearing came after a federal investigation began last fall into allegations that a Kentucky donation group pressured a hospital in 2021 to proceed with plans to withdraw life support and retrieve organs from a man despite signs that he might be waking up from his drug overdose. That surgery never happened after a doctor noticed him moving and moaning while being transported to the operating room — and the man survived. Lawmakers stressed most organ donations proceed appropriately and save tens of thousands of lives a year. But the federal probe – concluded in March but only made public ahead of Tuesday's hearing -- cited a 'concerning pattern of risk' in dozens of other cases involving the Kentucky group's initial planning to recover someone's organs. The report said some should have been stopped or reassessed earlier, and mostly involved small or rural hospitals with less experience in caring for potential organ donors. The Kentucky organ procurement organization, or OPO, has made changes and the national transplant network is working on additional steps. But notably absent Tuesday was any testimony from hospitals – whose doctors must independently determine a patient is dead before donation groups are allowed to retrieve organs. Here's a look at how the nation's transplant system works. There's a dire need for organ donation More than 100,000 people are on the U.S. transplant list and about 13 a day die waiting, according to the Organ Procurement and Transplantation Network. Only about 1% of deaths occur in a way that allows someone to even be considered for organ donation. Most people declared dead in a hospital will quickly be transferred to a funeral home or morgue instead. How the U.S. organ transplant system is set up Several groups are involved in every transplant: the hospital caring for someone dead or dying; the 55 OPOs that coordinate recovery of organs and help match them to patients on the waiting list; and transplant centers that decide if an organ is the right fit for their patients. Adding to the complexity, two government agencies — HRSA, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services — share regulatory oversight of different parts of the donation and transplant process. How deceased donation works Most organ donors are brain-dead – when testing determines someone has no brain function after a catastrophic injury. The body is left on a ventilator to support the organs until they can be retrieved. But increasingly organs are donated after circulatory death, called DCD – when people die because their heart stops. It usually happens when doctors determine someone has a nonsurvivable injury and the family withdraws life support. Donation groups don't provide hands-on patient care Hospitals are required to alert their area OPO to every potential donor who is declared brain-dead or once the decision to withdraw life support is made. The OPOs by law can't participate in that decision and "we are not even in the room at that time,' said Barry Massa of Kentucky's Network for Hope. During the following days of preparation, hospital employees continue caring for the patient – while the donation team talks with the family about the process, gathers hospital records showing the patient is eligible, requests tests of organ quality, and make arrangements with transplant centers to use them. Once the hospital withdraws life support and the heart stops beating there's a mandatory wait – five minutes – to be sure it won't restart. When the doctor declares death, the organ retrieval process can begin. Organs are only considered usable if death occurs relatively quickly, usually up to about two hours. Sometimes that takes much longer and thus the organs can't be used – and HRSA's Dr. Raymond Lynch told Congress that doesn't necessarily mean anything was done wrong. Still, he said HRSA is investigating reports of possible mistakes elsewhere. 'This is a technically demanding form of care' that requires 'good collaboration between the OPO and the hospital,' he said. What happens next At issue is how doctors are sure when it's time to withdraw life support from a dying patient — and the delicate balance of how OPOs interact with hospital staff in preparing for donation once death occurs. In May, HRSA quietly ordered the U.S. transplant network to oversee improvements at the Kentucky OPO and to develop new national policies making clear that anyone – family, hospital staff or organ donation staff – can call for a pause in donation preparations any time there are concerns about the patient's eligibility. Lynch said the government now wants more proactive collaboration from OPOs to give hospital staff 'a clear understanding' of when to at least temporarily halt and reevaluate a potential donor if their health status changes. Kentucky's Massa said his group only received HRSA's reports this week – but that after learning about last fall's allegations, it made some changes. Massa said every hospital doctor and nurse now gets a checklist on caring for potential donors and how to pause when concerns are raised — and anyone can anonymously report complaints. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content. Solve the daily Crossword
The Independent
2 days ago
- Health
- The Independent
US organ donation system faces scrutiny and changes after reports of disturbing near-misses
The U.S. is developing new safeguards for the organ transplant system after a government investigation found a Kentucky group continued preparations for organ donation by some patients who showed signs of life, officials told Congress Tuesday. While the organ removals were canceled, near misses that some lawmakers called horrifying should never happen. A House subcommittee asked how to repair trust in the transplant network for potential organ donors and families -- some of whom have opted out of donor registries after these cases were publicized. 'We have to get this right,' said Rep. Brett Guthrie, a Kentucky Republican who chairs the Energy and Commerce Committee and whose mother died waiting for a liver transplant. 'Hopefully people will walk away today knowing we need to address issues but still confident that they can give life,' Guthrie said, adding that he will remain a registered organ donor. The hearing came after a federal investigation began last fall into allegations that a Kentucky donation group pressured a hospital in 2021 to proceed with plans to withdraw life support and retrieve organs from a man despite signs that he might be waking up from his drug overdose. That surgery never happened after a doctor noticed him moving and moaning while being transported to the operating room — and the man survived. Lawmakers stressed most organ donations proceed appropriately and save tens of thousands of lives a year. But the federal probe – concluded in March but only made public ahead of Tuesday's hearing -- cited a 'concerning pattern of risk' in dozens of other cases involving the Kentucky group's initial planning to recover someone's organs. The report said some should have been stopped or reassessed earlier, and mostly involved small or rural hospitals with less experience in caring for potential organ donors. The Kentucky organ procurement organization, or OPO, has made changes and the national transplant network is working on additional steps. But notably absent Tuesday was any testimony from hospitals – whose doctors must independently determine a patient is dead before donation groups are allowed to retrieve organs. Here's a look at how the nation's transplant system works. There's a dire need for organ donation More than 100,000 people are on the U.S. transplant list and about 13 a day die waiting, according to the Organ Procurement and Transplantation Network. Only about 1% of deaths occur in a way that allows someone to even be considered for organ donation. Most people declared dead in a hospital will quickly be transferred to a funeral home or morgue instead. How the U.S. organ transplant system is set up Several groups are involved in every transplant: the hospital caring for someone dead or dying; the 55 OPOs that coordinate recovery of organs and help match them to patients on the waiting list; and transplant centers that decide if an organ is the right fit for their patients. Adding to the complexity, two government agencies — HRSA, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services — share regulatory oversight of different parts of the donation and transplant process. How deceased donation works Most organ donors are brain-dead – when testing determines someone has no brain function after a catastrophic injury. The body is left on a ventilator to support the organs until they can be retrieved. But increasingly organs are donated after circulatory death, called DCD – when people die because their heart stops. It usually happens when doctors determine someone has a nonsurvivable injury and the family withdraws life support. Donation groups don't provide hands-on patient care Hospitals are required to alert their area OPO to every potential donor who is declared brain-dead or once the decision to withdraw life support is made. The OPOs by law can't participate in that decision and "we are not even in the room at that time,' said Barry Massa of Kentucky's Network for Hope. During the following days of preparation, hospital employees continue caring for the patient – while the donation team talks with the family about the process, gathers hospital records showing the patient is eligible, requests tests of organ quality, and make arrangements with transplant centers to use them. Once the hospital withdraws life support and the heart stops beating there's a mandatory wait – five minutes – to be sure it won't restart. When the doctor declares death, the organ retrieval process can begin. Organs are only considered usable if death occurs relatively quickly, usually up to about two hours. Sometimes that takes much longer and thus the organs can't be used – and HRSA's Dr. Raymond Lynch told Congress that doesn't necessarily mean anything was done wrong. Still, he said HRSA is investigating reports of possible mistakes elsewhere. 'This is a technically demanding form of care' that requires 'good collaboration between the OPO and the hospital,' he said. What happens next At issue is how doctors are sure when it's time to withdraw life support from a dying patient — and the delicate balance of how OPOs interact with hospital staff in preparing for donation once death occurs. In May, HRSA quietly ordered the U.S. transplant network to oversee improvements at the Kentucky OPO and to develop new national policies making clear that anyone – family, hospital staff or organ donation staff – can call for a pause in donation preparations any time there are concerns about the patient's eligibility. Lynch said the government now wants more proactive collaboration from OPOs to give hospital staff 'a clear understanding' of when to at least temporarily halt and reevaluate a potential donor if their health status changes. Kentucky's Massa said his group only received HRSA's reports this week – but that after learning about last fall's allegations, it made some changes. Massa said every hospital doctor and nurse now gets a checklist on caring for potential donors and how to pause when concerns are raised — and anyone can anonymously report complaints. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Associated Press
2 days ago
- Health
- Associated Press
US organ donation system faces scrutiny and changes after reports of disturbing near-misses
WASHINGTON (AP) — The U.S. is developing new safeguards for the organ transplant system after a government investigation found a Kentucky group continued preparations for organ donation by some patients who showed signs of life, officials told Congress Tuesday. While the organ removals were canceled, near misses that some lawmakers called horrifying should never happen. A House subcommittee asked how to repair trust in the transplant network for potential organ donors and families -- some of whom have opted out of donor registries after these cases were publicized. 'We have to get this right,' said Rep. Brett Guthrie, a Kentucky Republican who chairs the Energy and Commerce Committee and whose mother died waiting for a liver transplant. 'Hopefully people will walk away today knowing we need to address issues but still confident that they can give life,' Guthrie said, adding that he will remain a registered organ donor. The hearing came after a federal investigation began last fall into allegations that a Kentucky donation group pressured a hospital in 2021 to proceed with plans to withdraw life support and retrieve organs from a man despite signs that he might be waking up from his drug overdose. That surgery never happened after a doctor noticed him moving and moaning while being transported to the operating room — and the man survived. Lawmakers stressed most organ donations proceed appropriately and save tens of thousands of lives a year. But the federal probe – concluded in March but only made public ahead of Tuesday's hearing -- cited a 'concerning pattern of risk' in dozens of other cases involving the Kentucky group's initial planning to recover someone's organs. The report said some should have been stopped or reassessed earlier, and mostly involved small or rural hospitals with less experience in caring for potential organ donors. The Kentucky organ procurement organization, or OPO, has made changes and the national transplant network is working on additional steps. But notably absent Tuesday was any testimony from hospitals – whose doctors must independently determine a patient is dead before donation groups are allowed to retrieve organs. Here's a look at how the nation's transplant system works. There's a dire need for organ donation More than 100,000 people are on the U.S. transplant list and about 13 a day die waiting, according to the Organ Procurement and Transplantation Network. Only about 1% of deaths occur in a way that allows someone to even be considered for organ donation. Most people declared dead in a hospital will quickly be transferred to a funeral home or morgue instead. How the U.S. organ transplant system is set up Several groups are involved in every transplant: the hospital caring for someone dead or dying; the 55 OPOs that coordinate recovery of organs and help match them to patients on the waiting list; and transplant centers that decide if an organ is the right fit for their patients. Adding to the complexity, two government agencies — HRSA, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services — share regulatory oversight of different parts of the donation and transplant process. How deceased donation works Most organ donors are brain-dead – when testing determines someone has no brain function after a catastrophic injury. The body is left on a ventilator to support the organs until they can be retrieved. But increasingly organs are donated after circulatory death, called DCD – when people die because their heart stops. It usually happens when doctors determine someone has a nonsurvivable injury and the family withdraws life support. Donation groups don't provide hands-on patient care Hospitals are required to alert their area OPO to every potential donor who is declared brain-dead or once the decision to withdraw life support is made. The OPOs by law can't participate in that decision and 'we are not even in the room at that time,' said Barry Massa of Kentucky's Network for Hope. During the following days of preparation, hospital employees continue caring for the patient – while the donation team talks with the family about the process, gathers hospital records showing the patient is eligible, requests tests of organ quality, and make arrangements with transplant centers to use them. Once the hospital withdraws life support and the heart stops beating there's a mandatory wait – five minutes – to be sure it won't restart. When the doctor declares death, the organ retrieval process can begin. Organs are only considered usable if death occurs relatively quickly, usually up to about two hours. Sometimes that takes much longer and thus the organs can't be used – and HRSA's Dr. Raymond Lynch told Congress that doesn't necessarily mean anything was done wrong. Still, he said HRSA is investigating reports of possible mistakes elsewhere. 'This is a technically demanding form of care' that requires 'good collaboration between the OPO and the hospital,' he said. What happens next At issue is how doctors are sure when it's time to withdraw life support from a dying patient — and the delicate balance of how OPOs interact with hospital staff in preparing for donation once death occurs. In May, HRSA quietly ordered the U.S. transplant network to oversee improvements at the Kentucky OPO and to develop new national policies making clear that anyone – family, hospital staff or organ donation staff – can call for a pause in donation preparations any time there are concerns about the patient's eligibility. Lynch said the government now wants more proactive collaboration from OPOs to give hospital staff 'a clear understanding' of when to at least temporarily halt and reevaluate a potential donor if their health status changes. Kentucky's Massa said his group only received HRSA's reports this week – but that after learning about last fall's allegations, it made some changes. Massa said every hospital doctor and nurse now gets a checklist on caring for potential donors and how to pause when concerns are raised — and anyone can anonymously report complaints. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Washington Post
3 days ago
- Health
- Washington Post
Organ retrieval reforms ordered after some donors showed 'signs of life'
Health and Human Services Secretary Robert F. Kennedy Jr. announced reforms to the nation's organ transplant system Monday, citing recent findings that the process of removing organs has on some occasions begun even when 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.
