Organ harvesting refers to the practice of removing usable organs from someone who is dead so that they can be transplanted into someone else. There is some dispute over the proper term for this procedure, since it involves delicate ethical and personal issues for many individuals. Some people may prefer the term "organ donation," which indicates that the organs were willingly surrendered to benefit other people. People around the world die every day because their organs go into failure and are unable to support life. Using organs from others who have passed away is a way to prevent these deaths, and it may also provide better quality of life for people like burn victims or individuals who have experienced severe ocular damage.
The first step in an organ donation is to determine that the donor patient is truly dead. The medical community defines death in a number of ways, but for organ transplant, the patient must meet the criteria for brain death or cardiac death. Brain death means that there is no brain activity and no hope of recovery, but the patient's heart is still beating and he or she is still breathing with the assistance of a ventilator. Cardiac death means that the patient's heart has stopped beating, although he or she may not be brain dead; this criteria is usually used in cases in which someone suffers from major head trauma, but still has some slight brain function, and therefore cannot be considered dead until his or her heart has stopped.
A series of tests are conducted to confirm brain death, ensuring that the patient is truly, irrevocably dead. This can be traumatic, as the patient appears to be alive, but he or she is not; sometimes hospital staff must actually use extreme measures to keep the patient "alive" so that the organs will continue to be viable. For cardiac death, the patient must be in cardiac arrest for at least two minutes.
Organ donation is only considered after it is clear that a patient has no hope of survival. Until that time, the focus is on getting the patient well again. One of the most enduring and unfortunate myths about organ harvesting is that it is performed on patients who are still alive, or that doctors circle dying patients like sharks to grab their organs. Organ transplantation is serious business, but so is death, and hospital staff and doctors take death very seriously.
If someone has indicated that he or she wishes to donate organs after death, a transplant team can immediately move in and initiate the harvesting process after consent forms are signed by someone with the power of attorney for the patient. In other instances, someone's wishes may be unclear, and hospital staff may discuss the options with the family. In all cases, a transplant coordinator discusses the possibility of organ donation before a harvest is begun, and the wishes of surviving family members are always respected; organs will never be removed without consent.
Once a medical team has received approval, the organ donor is wheeled into an operating room and cut open so that his or her organs and tissues can be removed. Typically, the donor has been blood typed and screened first, and a transplant coordination agency, such as the United Network for Organ Sharing in the United States, has assigned organs to people in need. Medical staff work quickly to keep organs usable, but they are also respectful, and they ensure that the patient is sewn up when the procedure is finished so that the family can visit the body as part of their grieving process, if desired.
After organ harvesting, the organs and tissues are rushed to their new destinations, and transplanted into patients in need. Some tissues have a longer shelf life, and they may be stored in medical facilities until they are needed. In the event that any donated organ or tissue is not usable, it is respectfully disposed of.
Organ donation can also be carried out with a living donor. The liver, for example, can regenerate, allowing someone to donate liver tissue to someone in need. Someone may also decide to offer up a single kidney. In other cases, people may donate skin for skin grafts or tissue such as bone marrow.
In some parts of the world, people have raised concerns about unethical organ harvesting, such as harvests from prisoners or political dissidents. It is difficult to substantiate claims of illegal harvesting, but it is clear that some people in developing nations do agree to sell their organs as living donors so that they can support themselves. This practice raises troubling issues in the field of medical ethics, as it is somewhat disturbing to think of people selling parts of themselves to survive.