His name is Anthony Donatelli and he had three months to live. A terminal illness forced him to depend on an organ donor to save him. Along the way, an opportunity arose: the organ resuscitation technique, PRN (normothermic regional perfusion). Donatelli became the first person in the world to receive this type of transplant three times at once. Victor Pretorius, surgical director at the University of California, performed the operation.
Back to life
“We use innovative technology. It allows us to obtain organs that historically would have been discarded,” says the physician. However, it is a controversial procedure. It circulates the dead person’s oxygenated blood inside his or her body until the organ starts beating again.
These are donors with irreversible catastrophic brain damage. They are kept alive artificially with the aid of life support. With the consent of the family, physicians perform PRN and disconnect life support.
Doctors then pump the donor’s blood to reactivate the functioning of the heart and lungs. This allows them to assess whether the organ is suitable for transplantation and also to prevent it from deteriorating. For many, it is like bringing someone back to life. So it raises profound ethical questions. But the American College of Physicians rejected the criticism. They said pumping blood into the thoracic organs does not change the fact that the heart will not restart on its own.
PRN “does not resuscitate the patient,” practitioners point out. The procedure pumps blood into the dead donor’s organs, but it does not revive him or her. It is an “honest, transparent and respectful” organ retrieval because death was declared “in an ethical manner.”
Restoring circulation, he argues, is simply another method of organ retrieval. “It’s not resuscitating the donor. Resuscitation means you’re going to restore longevity or quality of life.”
The decision about the patient’s death, he adds, occurs when the family decides to withdraw life support. The technique for resuscitating organs still raises much debate in the United States. Meanwhile, it continues to advance in developed countries. There are currently pilot plans in countries such as Switzerland, the Netherlands, Norway and Canada.