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Friday, June 08, 2012


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Bill Peckham

I think we have to see the world as it is; we should not ignore uncomfortable truths.

If people are recovering from supposed brain death, then that should have been enough to trigger a careful evaluation of the previous standards. Yet now we have a loosening of criteria without evidence that cases like the Dunlap's were taken into consideration at all.

I understand the desire to increase the supply of kidneys but it can not be at all costs. I agree that there does seem to be a belief among too many in the transplant community that those who need an organ should be privileged over everyone else.

Peter Laird, MD

There is a lot of research on brain death criteria and a recent study showed strict criteria can essentially eliminate any aspects of false diagnosis. I will try to find the reference but they added several different criteria and had no false declarations of brain death in a large series.

Instead of complaining about the general public questioning brain death criteria, I believe that the renal community should embrace stricter criteria to protect the public's perception of organ donation. Just my opinion which appears to be a minority opinion in the renal community.


I have to wonder just how prevalent this "harvest organs at all costs" mindset really is. I am listed at two tx centers in two different states, and at no time has anyone expressed ANY deviation from current ethical guidelines. As a matter of fact, I got a call for a possible DCD kidney from a 12 month old infant, and it was thoroughly explained to me that no one had any idea how long it would take for the child's heart to stop beating after being removed from life support and that if it took too long, all organs would be rendered unuseable. It was a horribly sad conversation, but far from what this supposed bioethicist is proposing, my personal experience makes me believe that this guy's reasoning is just not going to stand up to any ethics test, and quite right, too.

One transplant nephrologist told me quite candidly that in her medical opinion, DCD kidneys should be avoided, and I intend to take her advice.

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