title: Organ procurement in forensic deaths: French developments.
abstract: Organ procurement and transplantation have grown steadily, and the need for organs will only rise in the future. Increasing the number of potential donors is therefore paramount. However, transplant coordination teams face refusals that can be linked to the contexts of the deaths, especially when they involve legal issues. In France, deaths involving legal proceedings are not uncommon (7-10%). In these cases, the prosecutor is immediately contacted, and makes the decision of whether to remove the involved organs. Refusals of this type represent 4% (approximately 30 cases per year) of obstacles to organ removals, and are governed by specific legislation. Thus, the prosecutor must arrange contact with a forensic pathologist and with the organ transplant teams to assemble all of the necessary elements for him to take the decision. To assist prosecutors in their decision making and to ensure them scientific rigour, the French Society of Forensic Medicine sought to develop a national recommendation to harmonise practices; it emerged in early 2013. The guideline makes practical recommendations, including among others: nominating local referents; writing regional protocols between judicial authorities, forensic pathologists and transplant teams; establishing terms for the forensic pathologist's intervention on the donor's body before and after a procurement. This recommendation by the French Society of Forensic Medicine aimed to combine two interests: addressing the shortage of organs, and fulfilling the requisites of a criminal investigation by standardising practices and encouraging communication.
authors.affiliation: Forensic Institute, University Lille North of France, CHU Lille, France yann.delannoy@univ-lille2.fr.
authors.forename: Yann
authors.initials: Y
authors.lastname: Delannoy
authors.affiliation: Department of Forensic Medicine, CHU Angers, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jousset
authors.affiliation: Biomedicine Agency, Northeast region, Lille, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Averland
authors.affiliation: Forensic Institute, University Lille North of France, CHU Lille, France.
authors.forename: Valéry
authors.initials: V
authors.lastname: Hedouin
authors.affiliation: Medico-Legal Institute of Paris, University Paris Descartes, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Ludes
authors.affiliation: Forensic Institute, University Lille North of France, CHU Lille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Gosset
mesh_terms: D005554:Forensic Medicine; D005602:France; D017408:Guidelines as Topic; D006801:Humans; D012955:Societies, Medical; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence*
keywords: Forensic medicine; medical law