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In the tense hours of a transplant, the recipient's old organs are removed and usually become an afterthought. The focus turns to the patient's new organs: Will there be bleeding, clotting, infection, rejection?
But questions about how the old organs are handled arose in a rare and disquieting case last month at the Nebraska Medical Center.
A New Zealand family whose 3½-year-old girl received multiple organs asked the hospital to save her old organs for a goodbye and cremation.
The medical center apparently agreed to do that, then misplaced the organs. Medical center spokeswoman Andrea McMaster said the hospital is investigating what happened. She said there's still a possibility the organs might be found.
McMaster said the situation might be informative for other transplant hospitals, and hospital officials are mulling over how to get the word out.
The child was in critical condition this week after a small intestine, liver, pancreas and kidney transplant in early February. From birth, she has battled an intestinal disease that led to the failure of organs.
Her parents declined in an interview to discuss the fact that the organs were lost. They did say that in New Zealand, it's not rare to return the recipient's removed organs to the family.
The parents kept a blog to update friends and family of the girl's condition. Before the transplant, they wrote that the “body is a gift from God, so it doesn't sit right” to simply throw out the old organs as medical waste. They wanted the old organs “for closure and a chance to say goodbye to this part of our journey and thank God we have the chance to do so.”
They also said in that message that the medical center had been “supportive of our unusual request and found a funeral director who will kindly cremate her organs at no charge.”
After the transplant occurred, the girl's old organs were lost. The parents blogged that they were “devastated” by the situation.
“We are just trying to get our head around why this might happen,” they wrote. “We just wanted these parts … to be disposed in a respectful and dignified way and now they are LOST.”
The parents said in the interview that they had no desire to criticize the Nebraska Medical Center. “They have essentially saved our daughter's life,” the mother said. “I don't want to offend people, and I don't want to be inappropriate.”
The medical center said it couldn't discuss the situation because the parents didn't authorize it.
Dr. Steven Hinrichs, chairman of pathology at the Nebraska Medical Center, said organs and surgically removed tissues are examined for abnormalities by a pathologist. Then they typically are put in containers and placed into storage lockers, held for seven weeks and taken to a mortuary for incineration.
Hinrichs said that once or twice a year families request that organs or tissue be returned to them after surgeries or transplantation, usually for religious reasons.
Katrina Bramstedt, who specializes in transplant ethics at the California Pacific Medical Center in San Francisco, said she has heard of requests to see the organs, but not to save them.
“It's kind of a kindness, or a beyond-what's-expected type request,” added Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.
However, he said, it's the family's right to make such a request. The hospital should have accommodated them if possible, he said.
He and Bramstedt said there can be religious reasons for wanting bodies to be buried whole, or body parts to be buried. Both cited some orthodox Jews who, after suicide bombings in Israel, collect body parts so they can be buried.
Caplan also said that some diseased organs may contain contagious infection, in which case they would be dispatched as infectious waste.
The New Zealand parents said in the interview that their request had less to do with their religion, which is Presbyterian, and more with the fact that it would have helped them deal with their daughter's medical odyssey.
Contact the writer:
444-1123, rick.ruggles@owh.com
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