The Ministry of Health and Welfare has given conditional approval for organ donations from people whose heart has stopped, which are not limited to donors meeting the clinical definition of “brain dead.”
Any organ that may be removed from the body five minutes after the heart stops beating can be considered for non-heart-beating donations, Department of Medical Affairs Director-General Shih Chung-liang (石崇良) said, adding that such donations were previously not accepted due to controversy over official pronouncements of death and the vitality of such organs.
The consensus to accept non-heart-beating donations was reached on Friday during a meeting convened by the ministry and, among others, allows terminally ill patients under the Hospice and Palliative Care Act (安寧緩和醫療條例) to donate their organs after they have signed a consent form to remove all life-sustaining equipment.
Regulations for non-heart-beating donations are to be announced within the month, he said.
During the removal of life-sustaining equipment, doctors and hospitals are authorized to use sedatives, antiseptics and anti-coagulation products on the patient to prevent discomfort or pain, as well as to maintain the vitality of the organs, Shih said.
However, no invasive equipment, such as extracorporeal membrane oxygenation machines, may be used, Shih said.
The patient must be allowed five full minutes of observation after the heart has stopped beating, with organ removal commencing only if the patient’s heart does not start beating during the observation period, Shih said.
Invasive measures, such as intubation, are allowed after the patient’s heart has stopped beating and they are officially pronounced dead to increase the chances of success, he said, adding that all organ recipients must be informed that organs originate with non-heart-beating donors before accepting a transplant.
If a person has agreed to donate more than one organ, they or their family may designate the recipient of one of the organs, Shih said, adding that the measures aim to encourage organ donation.
The primary difference between non-heart-beating donation and brain-dead donation is that after brain death, the heart is still beating, facilitating the removal of organs with their vitality intact, Shih said.
Taiwan Organ Registry and Sharing Center President Lee Po-chang (李伯璋) said the regulation was a good thing, adding that the center estimated organ donations could grow by 20 to 30 percent next year.
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