Anencephalic Newborns: A Source of Transplantable Organs?

Abstract

A severe shortage of transplantable organs exists for in fants and children with life-threatening cardiac, renal, and hepatic disease. Newborns with anencephaly, a uni formly fatal neurological lesion, have been successfully used as sources of hearts and kidneys for transplanta tion. Both the number of anencephalic births each year as well as evidence that most of the organs from anence phalics are morphologically and functionally normal suggest that anencephalics could significantly contrib ute to the number of available infant organs. In addition, many parents of anencephalics have actively sought op portunities to donate their newborn's organs to achieve some good from an otherwise tragic pregnancy. In the United States, it is illegal to use anencephalics as organ sources until they are brain dead. One program recently employed intensive life support to sustain anencephal ics after birth until they became brain dead, but the program was terminated when only 2 of the 12 anence phalics enrolled eventually met brain-death criteria. Many believe that anencephalics, unique by virtue of their severe and imminently fatal neurological lesion, ought to be considered potential organ sources without regard for brain-death criteria. Several of these ethical formulations are analyzed and discussed.