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Anencephalic infants: life expectancy and organ donation
J J Pomerance1, A Morrison, R L Williams
1Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Summary
Anencephalic infants can potentially live longer with modern intensive care, offering a unique opportunity for organ donation. Current laws may need revision to allow extended support for this purpose.
Area of Science:
- Medical Ethics
- Neonatal Intensive Care
- Organ Donation
Background:
- Anencephalic infants historically received minimal support, with some surviving over a week.
- Modern neonatal intensive care may significantly extend survival times for anencephalic infants.
Purpose of the Study:
- To evaluate the potential for extended ventilatory support in anencephalic infants for organ donation.
- To advocate for legal changes permitting longer support for organ procurement.
Main Methods:
- Review of historical data on anencephalic infant survival.
- Analysis of preliminary data from neonatal organ transplantation centers regarding ventilatory support duration.
Main Results:
- Nearly 9% of anencephalic infants born between 1978-1982 survived over a week with minimal support.
- Seven to 14 days of ventilatory support are feasible without brainstem death in specialized centers.
Conclusions:
- Anencephalic infants represent a special case for organ donation, not meeting brain death criteria.
- Parents should be permitted to continue ventilatory support for organ donation purposes.
- Legal frameworks should be updated to facilitate organ donation from anencephalic infants.
Keywords:
Health Care and Public Health