Proposal may make death in Taiwan a matter of the heart

Ko, the chief of National Taiwan University Hospital's traumatology department, said that, according to the National Organ Transplant Act, organ transplants in Taiwan require a declaration of neurological death from two doctors.

“Some registered donors have not had their organs donated as they were declared dead in a cardiac sense before being pronounced brain dead,” Ko said.

According to local reports, an average of 7,000-8,000 people await organ transplants annually. There were less than 200 individual organ donors last year.

Ko said depending on the age of organ donors, the time required to determine neurological death ranges from four to 24 hours. However, five minutes after the heart stops beating, blood coagulation takes place. Therefore, the determination of death is distinct when comparing neurological death organ donors and cardiac death organ donors.

“Even though I suggested that two minutes without a heart beat is the determination of death,” Ko said, “different time frames can still be discussed.”

TORSC Chairman Dr. Lee Po-chang (李伯璋) said that medical teams would have less time to carry out organ transplants on cardiac death organ donors compared to the time they have on neurological death organ donors.

Ko said that TORSC and other medical experts will consider whether the family members of organ donors will accept such a proposal, as declaring a person to have died according to the cardiac assessment takes less time than for neurologically dead patients.

According to Lee, many countries, including the United States, Japan, and some countries in Europe, have already approved undertaking organ transplant on donors who have died in a cardiac sense, becoming a third source of organ donation alongside neurological death organ donation and live organ donation.

According to local reports, 8-25 percent of patients who required renal transplants received kidneys from organ donors who suffered a cardiac death in countries that approved cardiac death organ donation.

Ko said that according to Criminal Law, if a doctor currently performs an organ transplant on a patient in Taiwan who has suffered cardiac death, the doctor may face criminal charges and be sentenced to one to five years in prison.

Proposed Cardiac Death Organ Donation Procedure

Step One: Two professional doctors declare the patient to be at or near the point of death.

Step Two: The patient's family members agree to withdraw artificial life supporting medications or devices.

Step Three: The patient's heart stops beating for at least two minutes.

Step Four: Organ transplant will be undertaken by medical teams.

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