best efforts should be made to develop reasonable solutions. At the same time, there should be a realistic understanding of the limitations of the NHBD given current technology and procedures. Both the lower numbers of organs per donor (because of their deterioration in the body of the donor) and the condition of the organs that are recovered limit the benefits, and undoubtedly increase the costs of NHBDs relative to other categories of donors. There also seems to be considerable inertia in developing procurement policies, as well as uncertainty and anxiety about the proper policies and procedures to adopt. In some OPOs, there is opposition to NHBDs, and because some of this opposition is said to reflect public concerns, it could be difficult to change. Identification, discussion, and if possible, resolution of some of the outstanding issues concerning the proper ethical and medical management of these donors might help to overcome this uncertainty or opposition if they are indeed among the reasons for the very slow expansion of the NHBD pool.



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