Vital role of medical examiners and coroners in organ transplantation.

Many people die owing to the shortage of donor organs. Medical examiners and coroners (MEs/Cs) play a vital role in making organs available for potential recipients. Medical examiners'/coroners' case data were collected using a structured confirmatory-recorded methodology for calendar years 2000-01 and were linked and analyzed with donor and transplant data from the United Network for Organ Sharing, predicting the nature and extent of the loss of donor organs. Nearly seven percent of ME/C cases were denied recovery during 2000-01. Because 353 and likely, 411 potential organ donors (PODs) were denied, as many as 1400 persons on transplant waiting lists did not receive organs because of ME/C denials. Problematically for pediatric patients awaiting transplantation, nearly half of all ME/C denials occurred in pediatric patients. Eighteen percent of PODs aged five or less and 44.2% of child abuse PODs were denied recovery by the ME/C. There were no (zero) denials in three of the five largest U.S. cities and in four states. Since 1994, two states have enacted legislation restricting the circumstances of ME/C denials, resulting in an 83% decrease in ME/C denials. Release of all organs from ME/C cases is needed urgently to protect the lives of those persons awaiting transplantation. Medical examiners and coroners deserve recognition for their efforts in advocating methods and/or regulation/legislation designed to achieve 100% release of life-saving organs for transplantation.