Medical Examiners, Coroners, and Organ Recovery in the United States

To the Editor.  —Ms Shafer and colleagues¹ have provided the transplant community with valuable information in the constant struggle to enhance donor organ resources. The relationship between a transplant center or donor hospital and the local coroner's office must be mutually supportive. The experience of the medical examiner of San Bernardino County, California, was recently reported.² Internal organs were recovered from homicide victims, including children, without significant problems occurring during subsequent legal proceedings. Organ recoveries increased by 60%. A detailed protocol was provided that could be used as a model by other ME/C offices.Two causes of death with particular pertinence to pediatric transplantation are sudden infant death syndrome (SIDS) and deaths due to suspected child abuse. Since November 1985 we have performed 262 heart transplantation procedures for 257 pediatric patients. Of these, SIDS represented 25 donors (9.5%) and suspected child abuse accounted for an additional 32 (12.2%).