It seems fitting that I would be writing this on the Easter holiday with the symbolism of death followed by resurrection being the principal path for an organ to live on in another after departing their host. This topic came across my radar this week after I caught the following article on NBC news that I would encourage you to take a look at as it really captures the state of this practice in the US at the moment.
The Littlest Donors:Neonatal Organ Donation Offers Hope in Tragedy
This may surprise you but there really is nothing in the literature about this. There was a flurry of articles about neonatal transplantation in the late 1980s as debate raged about the ethics of using anencephalic newborns as donors but since then very little. I could find one article in pubmed which is a basic science article showing that mid trimester fetuses lung tissue can be used to regenerate cells in a recipient lung scaffold many hours after the stillbirth had occurred with the longest duration being 41 hours in this study. It would seem based on this study that the capacity for stillborn tissue to survive outside the deceased in theory then could provide a window for obtaining consent although how long such whole organs would last is uncertain.
The Big Questions?
How as a medical society we could manage this is a challenging one. Consent would only be possible after the recognition of fetal loss and who knows how long a window there would be from the time of death until the baby was delivered. Approaching families to ask about organ donation after they have just suffered a fetal loss is a difficult task to say the least. On the other hand the opportunity for some families to have some good come out of their tragedy as the NBC article points out may be therapeutic in some way.
Lastly, there is no question that there is a need for small organs. Having worked previously in a centre that offered cardiac transplantation I recall waiting for available hearts that never came or came too late. The challenge is that the thorax is only so big in a newborn and can’t accommodate a heart from a child or adult. Add to this that certain conditions preclude a baby or child from donating depending on the cause of death and having access to a larger pool of potential organs could indeed change the landscape of organ transplantation.
I should also stress that I am not talking about Planned Parenthood who has been accused of selling aborted fetuses tissue (having said that I can find little hard evidence for these claims out there). These are all babies who have been stillborn and not intentionally born to harvest organs.
I doubt this is the last you will hear of this but as the topic becomes more mainstream I can see ethicists and legal teams coming to the forefront to tackle this at each hospital and across many countries. It will be intriguing to follow this story and see how it unfolds.
My name is Maya, when I was 17 my daughter was still born. She was alive one minute and gone the next, heartbreaking. But I made the difficult and bitter sweet decision to donate her organs and in the process helped save a baby girl with a heart deffect in the NICU on the floor above me… I will never forget the look on the parents face when they were told their beautiful baby girl was indeed going to live.
I suffered placenta abruption in the hospital while resulted in my daughter being stillborn I myself am an organ diner they were quick to get consent about me but never about my daughter I only thought about it later after her burial and today after watching a story about a little girls passing and her family donating her organs did I look up can you donate a stillborn baby’s organs
I wish I had been asked about this asI would have loved to have been able to help save another even in my great loss I believe they should approach parents about this it’s in the presentation that would help not come across as harsh or uncaring maybe an informational sign in the rooms about how many are in need could get the idea going
I’m confused why it’s ok to approach parents of a toddler or young child but not a stillborn baby parents of stillbirth baby’s already have issues with many comments about it not being a real baby so why a service or burial to even insensitive doctors saying you had a miscarriage
Well my miscarriage was very close to her due date and I had to go shopping for a burial gown she was larger than her sisśter she was full term ugh that was very upsetting
I am sorry for your loss but do appreciate you sharing your story with us
I would love to speak more on this topic. I had an intrapartum stillbirth in Dec of 2016 in Tennessee, USA and the conversation I had about organ donation was handled poorly. I regret not exploring this option more, but as a healthcare worker myself, I know the communication should have been different. I’d love to share my experience to promote change.
I am sorry to hear of your loss. You might find some solace in writing about it. Can be cathartic