When does life end?

Jennifer Couzin-Frankel in Science:

On a chilly holiday Monday in January 2020, a medical milestone passed largely unnoticed. In a New York City operating room, surgeons gently removed the heart from a 43-year-old man who had died and shuttled it steps away to a patient in desperate need of a new one.

More than 3500 people in the United States receive a new heart each year. But this case was different—the first of its kind in the country. “It took us 6 months to prepare,” says Nader Moazami, surgical head of heart transplantation at New York University (NYU) Langone Health, where the operation took place. The run-up included oversight from an ethics board, education sessions with nurses and anesthesiologists, and lengthy conversations with the local organization that represents organ donor families. Physicians spent hours practicing in the hospital’s cadaver lab, prepping for organ recovery from the donor. “We wanted to make sure that we controlled every aspect,” Moazami says.

That’s because this donor, unlike most, was not declared dead because of loss of brain function. He had been suffering from end-stage liver disease and was comatose and on a ventilator, with no hope of regaining consciousness—but his brain still showed activity. His family made the wrenching choice to remove life support. Following that decision, they expressed a wish to donate his organs, even agreeing to transfer him to NYU Langone Health before he died so his heart could be recovered afterward.

More here.