Feasibility of postmortem device acquisition for potential reuse in underserved nations

Objectives The purpose of the present study was to examine the feasibility and efficacy of a program to acquire devices with adequate battery life from crematories and funeral homes for potential reutilization in underserved nations. Background There exists a great health-care disparity between the industrialized world and underserved nations—specifically in the frequency of pacemaker implantation. Methods Flyers were mailed to all 1057 members of the Michigan Funeral Directors Association providing information to download a consent-for-explant form and request a postage-paid envelope from www.myheartyourheart.org in order to send explanted devices. Donated devices from funeral homes and crematories nationwide were also collected from World Medical Relief. Adequate battery life was defined as ≥75% or ≥4 years of estimated longevity. Results A total of 3176 devices (65% pacemakers, 21% implantable cardioverter-defibrillators [ICDs], 12% biventricular ICDs, and 3% biventricular pacemakers) were donated to the reutilization program. Five hundred fifty devices (21%; 95% confidence interval [CI] 19.4–22.6%) were found to have an acceptable battery life for reutilization. Among these devices, 313 were pacemakers (17.9%; 95% CI 16.1–19.8%), 118 were ICDs (17.9%; 95% CI 15.1–21.1%), 112 were biventricular ICDs (30.3%; 95% CI 25.6–35.2%), and 7 were biventricular pacemakers (17.3%; 95% CI 16.0–18.7%). Conclusions Approximately 21% of donated devices and 30% of donated biventricular ICDs possess an adequate battery life for potential reuse. Device donations from funeral homes and crematories appear to be a potential resource for device reutilization for those in need in underserved nations.