Harvesting of Baby Organs Not Feasible : Loma Linda Tells Why It Dropped Anencephalic Infants Program

Loma Linda University Medical Center officials said Tuesday that their recent decision to suspend a controversial nine-month program to use brain-dead babies as organ donors was based on the conclusion that the procedure is medically unfeasible in most cases, based on current knowledge.

In December, 1987, Loma Linda adopted a “protocol” providing medical, legal and ethical guidelines under which a baby born with a fatal defect called anencephaly could be sustained on a respirator so that its vital organs would not deteriorate. Without life-sustaining equipment, anencephalic babies--who are missing parts of their brain and skull--usually die within a few days of birth.

Failed Attempts

Thus far, 13 attempts to harvest critical donor organs such as hearts and livers from these babies under the protocol have failed, said Dr. Joyce Peabody, chief of Loma Linda’s neonatology division, at a press conference.

“Two of the key things that we learned were first, if you provide full intensive care to give the best chance of keeping the organs healthy and viable, brain stem death does not occur within its natural time period, and therefore, these infants cannot legally be considered as organ donors,” Peabody said. The brain stem controls such activities as reflex movements and breathing.

Shortage of Oxygen

“Second, if intensive care is delayed until imminent death begins to develop, then there is a risk that the organs will already be damaged by oxygen shortage and cannot be used,” Peabody said. “And there is still evidence that even when intensive care is delayed, if it successfully resuscitates activity to the heart and liver, it also restores activity of the brain stem.”

The situation has taken an emotional toll on Loma Linda staff members who cared for the babies in the program, she said.

“The problem has been difficult for the staff because they were watching babies die,” Peabody said. “We decided it was time to undergo an extensive reevaluation.”

Also at the press conference, Loma Linda President Dr. David B. Henshaw for the first time announced the cost of the program to the medical center, which he said does not receive financial assistance for such “pioneering medicine” from state or federal government sources.

“The cost has been substantial, about $250,000,” Henshaw said. However, he said the program was not halted for budgetary reasons.

Similar Protocol

Meanwhile, Peabody said that at least “four or five medical centers across the nation” are using a similar protocol to try and harvest organs from anencephalic babies. Although she declined to name the medical centers, “none of them have succeeded,” she said.

Peabody said she is writing a report on the results of the protocol to be published in a medical journal sometime in the early fall.

Beyond that, “our next step is not immediately obvious,” Peabody said. However, she encouraged other medical institutions to “enter the arena.”

“I would encourage them to enter the arena and help us with it,” Peabody said. “I would applaud them for it and suggest they give us a call so we can share our results with them.”