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The first organ transplant from a brain-dead donor

From the Institute of Neurology and Neurosurgery, Havana, Cuba.

Address correspondence and reprint requests to Dr. C. Machado, Cuban Commission for the Determination and Certification of Death, Institute of Neurology and Neurosurgery, Apartado Postal 4268, Ciudad de La Habana 10400, Cuba; e-mail: braind{at}infomed.sld.cu

In 1968, publication of the Harvard committee’s report concerning "irreversible coma" established a paradigm for defining death by neurologic criteria (brain death [BD]). Five years earlier, Dr. Guy Alexandre, a Belgian surgeon, had not only adopted closely similar diagnostic criteria for BD but also applied those criteria in performing the first organ transplant from a brain-dead donor—a procedure many of his colleagues considered ethically unacceptable. To put those events into present-day perspective, the author reviewed the proceedings of a Ciba Symposium held in London in 1966 at which Alexandre introduced his pioneering view, obtaining information and documents from Alexandre and others who attended that meeting. Comparing Alexandre’s approach with the Harvard report and later advances helps in understanding how both defining death by brain criteria and transplanting organs from a brain-dead donor have become morally tolerable today.

C.M. received the Lawrence C. McHenry Award from the American Academy of Neurology (AAN) for this work, which was presented in Miami, FL, on April 13, 2005, at the 57th Annual Meeting of the AAN.

Received May 17, 2004. Accepted in final form February 15, 2005.

This article has been cited by other articles:

				C Machado, J Korein, Y Ferrer, L Portela, M d. l. C Garcia, M Chinchilla, Y Machado, Y Machado, and J M Manero The Declaration of Sydney on human death J. Med. Ethics, December 1, 2007; 33(12): 699 - 703. [Abstract] [Full Text] [PDF]

				C. Machado, J. Kerein, Y. Ferrer, L. Portela, M. de la C Garcia, and J. M Manero The concept of brain death did not evolve to benefit organ transplants J. Med. Ethics, April 1, 2007; 33(4): 197 - 200. [Abstract] [Full Text] [PDF]

				E. F.M. Wijdicks and C. Machado The first organ transplant from a brain-dead donor Neurology, February 14, 2006; 66(3): 460 - 461. [Full Text] [PDF]

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