Dead Donor Rule - New Law Prevents Violations

The dead donor rule has been a fixture of organ transplantation for sixty years. But in light of frequent intentional and accidental breaches, some regulators have strengthened protections to mitigate DDR violations. 

Notable among these is Kentucky H.B. 510, signed in April. Because the law is now effective, it has been receiving renewed attention.

The Kentucky statute requires that "during any organ donation recovery, preservation, or procurement activity for a DCD or DBD, a pause in procedure shall be initiated if any [clinician or family member] reports on any of the following:

1. Observed or suspected change in neurological status
2. Observed or suspected indication of life
3. Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments"

Triggering "indications of life" include but are not limited to:

1. Spontaneous movement
2. Vocalization or attempts to vocalize
3. Purposeful or reflexive responses to stimuli
4. Observed respiratory effort by a patient-initiated attempt at breath
5. Changes in heart rate or blood pressure inconsistent with a death declaration
6. Any neurological or physiological sign suggesting pain perception or neurological activity

Reports of any of these require "immediate suspension of any organ donation recovery, preservation, or procurement activity."