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Thursday 21st June 2018

'Dead' patient wakes up

16th June 2008

A 45 year-old man pronounced dead and whose organs were about to be removed for transplant came around on the operating table, raising concerns about current definitions of death.

heart surgery

The man, a heart-attack victim, recovered after a long period in intensive care at the La Pitie-Salpetriere hospital in Paris.

Now able to walk and talk, the man owes his life to the fact that surgeons authorised to remove organs for transplant operations were not immediately available.

France may now have to reconsider its medical definition of death, which was adopted on a trial basis last year to make more organ transplants possible.

The rules, which require that a patient's heart has stopped and failed to respond to prolonged massage, also operate in several other European countries including the United Kingdom.

The hospital's ethics committee said the situation illustrated questions that remained in resuscitation, and what criteria could be used to determine that a resuscitation had failed.

The committee acknowledged that doctors and the state have an obligation to the 13,000 people waiting for transplanted organs in France, where 231 patients died because they could not obtain organs for transplant.

The government introduced experimental rules allowing the removal of organs in nine hospitals from so-called "stopped heart" patients, in an attempt to expedite transplants.

Medical staff spent at least 90 minutes trying to revive the 45 year-old man, who collapsed near the hospital. As they were preparing him for the removal of vital organs, the man began to breathe unaided, his heart started to beat and he began to feel pain.

The ethics committee said several other similar situations had been brought to its attention among medical personnel who specialised in resusciation.

Some now say the existing rules are too imprecise, and could undermine public support for the removal of organs for transplant.

The issue may now be tabled during a consultation process next year for a proposed piece of legislation on medical ethics.

French specialist Alain Tenaillon said all the specialist literature suggested that anyone whose heart had stopped and had been massaged correctly for more than 30 minutes was probably brain dead.

But he said the medical establishment needed to accept that there were sometimes exceptional cases, and that there were no absolute rules.


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