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The timing of organ donation after cardiocirculatory death is biologically crucial for the recipient but remains ethically controversial for the donor, however well-considered the judgment of experts and organizations that issue general recommendations and of clinicians in each individual case. Is there a way out of this labyrinth?
In a feasibility trial, hearts from donors who had died from cardiocirculatory causes were successfully transplanted into three infants in the highest-risk waiting-list category (mean age, 2.2 months) with complex congenital heart disease or severe cardiomyopathy. Donors (mean age, 3.7 days) had severe birth asphyxia resulting in devastating neurologic injury (but not brain death). After informed consent was obtai…