This Article Full Text (PDF) Services E-mail this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Search for Related Content

Infants with Anencephaly as Organ Sources: Ethical Considerations

BACKGROUND

Pediatric organ transplantation offers an increasing number of seriously ill children the opportunity for a healthy life. However, there is currently a severe shortage of pediatric organs. Young children rarely die in circumstances that would make them medically acceptable sources of organs. Among the children younger than 2 years of age registered to receive transplants, an estimated 30% to 50% die before an organ becomes available.¹ In April 1990, the United Network for Organ Sharing reported 320 children younger than 5 years of age waiting for kidney (99), liver (178), heart (34), or heart-lung (9) transplants. Although improved organization of the organ procurement system could partially ameliorate the problem, in all likelihood, pediatric organs will remain a scarce medical resource.²

Anencephaly is a congenital defect in which the cranium is absent and the cerebral cortex is virtually absent. However, vital organs, such as the heart and kidneys, are often normal. About 1000 to 2000 live anencephalic births occur annually in this country. Brain stem function enables many anencephalic infants to survive for hours or days and, in rare cases, for a few weeks.³

In recent years, some parents of anencephalic infants, as well as some transplant surgeons, medical ethicists, and state legislators, have proposed that these infants' organs be used for transplantation.^4,5 Some parents have poignantly expressed their wish that some good might come of their loss. In their opinion, there is no compelling reason for failing to use an anencephalic infant's organs to give life and health to other children.

Statement of reaffirmation:

AAP Publications Retired or Reaffirmed, October 2006

American Academy of Pediatrics
Pediatrics 2007 119: 405. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				C. A. Zawistowski and M. A. DeVita Non-Heartbeating Organ Donation: A Review J Intensive Care Med, July 1, 2003; 18(4): 189 - 197. [Abstract] [PDF]

				L. F. Ross, D. T. Rubin, M. Siegler, M. A. Josephson, J. R. Thistlethwaite, and E. S. Woodle Ethics of a Paired-Kidney-Exchange Program N. Engl. J. Med., June 12, 1997; 336(24): 1752 - 1755. [Full Text]

				W. D. Caplan, T. R. Cooper, J. A. Garcia-Prats, and B. A. Brody Diffusion of Innovative Approaches to Managing Hypoplastic Left Heart Syndrome Arch Pediatr Adolesc Med, May 1, 1996; 150(5): 487 - 490. [Abstract] [PDF]

				Council on Ethical and Judicial Affairs, American, J. Glasson, C. W. Plows, O. W. Clarke, J. H. Cosgriff Jr, C. H. Kliger, V. N. Ruff, R. M. Tenery Jr, G. T. Wilkins Jr, D. Orentlicher, et al. The Use of Anencephalic Neonates as Organ Donors JAMA, May 24, 1995; 273(20): 1614 - 1618. [Abstract] [PDF]