NYC Takes Unprecedented Step With At-Home Organ Recovery
NEW YORK (CBS 2 / WCBS 880 / AP/1010 WINS) – It’s never been done in the United States before, but if a new organ preservation pilot program launched by Mayor Michael Bloomberg succeeds, officials think they could wipe out the lists of critically ill New Yorkers waiting for donor organs in order to live.
At first there was just intense grief when Nick Nowillo died two years ago, beaten as he tried to stop a homeless man breaking into a neighbor’s car.
“He just took his life in the blink of and eye. He was a good man a good father,” daughter Sandra Nowillo-Khan told CBS 2′s Marcia Kramer.
But the family used their loss for other’s gain, donating Nick’s organs so others could live.
“My father was able to donate his skin, which saved over 50 people, his eyes and bone marrow, his bones,” daughter Doris Nowillo-Suda said.
So it was with great pride and anticipation that Nowillo-Suda, clutching her dad’s picture, took part in a press conference with Mayor Bloomberg on Wednesday to announce a first in the nation pilot program to harvest organs from people — until now unable to donate because they died of heart attacks outside hospitals.
“Shame on us if we don’t take all of the steps that we can between those who need kidney transplants and those who have indicated their desire to be organ donors,” Bloomberg said.
WCBS 880′s Paul Murnane reports
Under the plan, families choosing whether to donate a loved one’s organs usually have days to grapple with their decision, all while the patient lies hooked up to machines in a hospital bed. But they would have only about 20 minutes to make the choice in the new pilot program.
That’s roughly how long a team of organ specialists will have after a cardiac-arrest patient is declared dead to arrive at the home, check a donor registry, determine medical eligibility, obtain a family member’s consent and get the person into a specialized ambulance.
The program launching Wednesday, the first of its kind in the U.S., according to organizers and other experts, could eventually lead to thousands more organs donated each year nationwide. But the six-month trial, a collaboration between Bellevue Hospital and New York City’s police and fire departments, could be declared a success without a single organ being recovered, organizers said.
Instead, what’s being tested is the ability of the team – composed of two EMTs, an organ donor family services specialist and a Bellevue emergency physician – to successfully interact with grieving and shocked family members in the limited time available before it is too late to use a person’s organs. A police detective will arrive at the scene before the team to make sure there’s nothing about the death that warrants a criminal investigation.
The project is “very, very modest but has the potential to prove a concept that could be revolutionary,” said Dr. Lewis Goldfrank, director of emergency services at Bellevue Hospital Center and the leader of the pilot, which is being funded with a $1.5 million grant from the U.S. Department of Health Resources and Services Administration.
Of the roughly 50,000 people who died last year in downstate New York-area hospitals, about 600 were judged eligible to donate their organs. Of those, only 261 became donors, said Elaine Berg, the president and CEO of the New York Organ Donation Network.
The small number is due in part to policies preventing the vast majority of people who die of cardiac arrest from becoming donors, said Goldfrank, who estimated that each year 350,000 to 450,000 people in the U.S. suffer cardiac arrest outside of a hospital, with most dying.
Only kidneys will be recovered in the pilot program. Last year, more than 4,650 people in the U.S. died while awaiting a kidney – accounting for 70 percent of deaths on the transplant list, according to the United Network for Organ Sharing.
As an ethical measure, EMTs attempting to revive a person and the doctor who ultimately makes the decision to declare a person dead won’t know whether the patient is a registered organ donor and whether he or she is considered a candidate for the pilot program.
Team members will be sent to the scene in a specialized organ preservation vehicle but will only enter the home after a person has been declared dead. Once there, they must determine whether the person is a registered organ donor and whether the person has any medical conditions – such as cancer or AIDS – that would eliminate them as candidates.
And they must get the permission of family in a matter of minutes.
That’s a task that the medical community has long considered nearly impossible, said Dr. Hasan Yersiz, director of organ procurement at the University of California Los Angeles.
“Think about it,” he said. ‘You have somebody dying and you have to make that decision very fast. It’s not an easy situation.”
The pilot program team has been told they have 50 minutes from the time a person’s heart stops beating to the time his or her body must be placed in the ambulance and hooked up to a machine that creates blood circulation. Once at Bellevue, another machine will increase body oxygen. Only residents of Manhattan who are between 18 and 59 will be eligible for the pilot program.
Similar programs are already in place in France and Spain, where there are fewer barriers because people in those countries are considered organ donors unless they opt out, Goldfrank said. In order to become a donor in U.S. hospitals, a person must have joined a government registry – in New York state it’s almost always done through the DMV – or family must consent to the procedure. The Manhattan pilot program requires both registration and family consent.
In America, “people are very concerned about protecting individual rights,” said Nancy Neveloff Dubler, a bioethicist with the Montefiore-Einstein Center for Bioethics who advised those developing the pilot program. “The technology is there, the question is will we use it for the good of people who are waiting for organs.”
(The Associated Press contributed to this report.)