Families choosing whether to donate a loved one's organs usually have days to grapple with their decision, all while the patient lies hooked up to machines in a hospital bed.
But they would have only about 20 minutes to make the choice in a new pilot program meant to recover organs from patients who die at home.
That's roughly how long a team of organ specialists will have after a cardiac-arrest patient is declared dead to arrive at the home, check a donor registry, determine medical eligibility, obtain a family member's consent and get the person into a specialized ambulance.
The program launching Wednesday -- the first of its kind in the U.S., according to organizers and other experts -- could eventually lead to thousands more organs donated each year nationwide. But the six-month trial, a collaboration between Bellevue Hospital and New York City's police and fire departments, could be declared a success without a single organ being recovered, organizers say.
Instead, what's being tested is the ability of the team -- composed of two EMTs, an organ donor family services specialist and a Bellevue emergency physician -- to successfully interact with grieving and shocked family members in the limited time available before it is too late to use a person's organs.
A police detective will arrive at the scene before the team to make sure there's nothing about the death that warrants a criminal investigation.
The project is "very, very modest but has the potential to prove a concept that could be revolutionary,'' said Dr. Lewis Goldfrank, director of emergency services at Bellevue Hospital Center and the leader of the pilot, which is being funded with a $1.5 million grant from the U.S. Department of Health Resources and Services Administration.
Of the roughly 50,000 people who died last year in downstate New York-area hospitals, about 600 were judged eligible to donate their organs. Of those, only 261 became donors, said Elaine Berg, the president and CEO of the New York Organ Donation Network.
The small number is due in part to policies preventing the vast majority of people who die of cardiac arrest from becoming donors, said Goldfrank, who estimated that each year 350,000 to 450,000 people in the U.S. suffer cardiac arrest outside of a hospital, with most dying.
Only kidneys will be recovered in the pilot program. Last year, more than 4,650 people in the U.S. died while awaiting a kidney --accounting for 70 percent of deaths on the transplant list, according to the United Network for Organ Sharing.
As an ethical measure, EMTs attempting to revive a person and the doctor who ultimately makes the decision to declare a person dead won't know whether the patient is a registered organ donor and whether he or she is considered a candidate for the pilot program.
Team members will be sent to the scene in a specialized "Organ Preservation Ambulance'' but will only enter the home after a person has been declared dead. Once there, they must determine whether the person is a registered organ donor and whether the person has any medical conditions.