The government is to allow organs to be taken from people before they are officially brain dead in an effort to tackle the shortage of transplant donors.

Guidelines being published in September will allow transplant surgeons to begin removing organs five minutes after a donor’s heart has stopped.

The move has raised concerns about the drive to harvest more organs from dying patients to meet a government target to increase transplant rates by 50% in the next five years.

The new code of practice for diagnosis and confirmation of death, produced on behalf of the health department, is the first set of rules in Britain to provide clinicians with such instructions.

It will give doctors permission to forgo a complex set of tests to establish brain stem death, which can take 20 minutes. The delay means that unless a donor is on life-support, their organs tend to be too badly damaged by oxygen starvation to be used.

Gordon Brown has also called for the introduction of presumed consent, whereby everyone would be treated as a potential donor at death unless they had notified their objection in advance.

The Patients’ Association says it has not been consulted on the issue of diagnosis of death. Vanessa Bourne, its chairwoman, said: “Who is going to advocate for people with no family?”

David Evans, a retired consultant anaesthetist who has long expressed doubts about the methods of defining death for organ donation purposes, said: “No one of scientific mind really believes you can diagnose death in these simplistic ways. By rushing to retrieve organs we are depriving ourselves of the simplest tool to diagnose death, which is the passage of time.”

Doctors in Paris recently reported that a 45-year-old heart attack victim had begun breathing again as surgeons prepared to retrieve his organs.

Last year in Frederick, Oklahoma, Zack Dunlap, 21, was declared dead after a quad-biking accident. Two cousins who were nurses had arrived as a transplant team was landing by helicopter and found he reacted to having his feet and hands touched. He has since made a full recovery.

Peter Simpson, former president of the Royal College of Anaesthetists who led the working party behind the new code, said he was confident such disasters would not occur in the UK.

“We are saying you must wait five minutes [before removing organs],” he said. “Five minutes of lack of circulation inevitably leads to brain damage but not necessarily damage that would meet the brain stem death criteria.”

He said the code was as much to protect people from overzealous resuscitation efforts as to give early signs of when organ retrieval might be appropriate.

“We have not had a lot of disagreement with this guideline, and I am anxious it is not taken the wrong way,” he said. “Diagnosis of death is not well taught.”

The move will increase the number of organs available. Stroke victims could become the biggest donor pool. Up to one in five of the 40,000 people who die annually as a result of strokes have hearts, lungs, livers and kidneys that can be reused.

Some transplant centres have already begun using livers and kidneys from donors whose hearts have stopped.

Steven Tsui, head of the heart transplant programme at Papworth hospital, Cambridge, said extraordinary efforts were made to ensure organs were not taken if there was the slightest hope of recovery. “In surveys more than 90% of the population approve of organ donation, but when they are asked to consent to the use of organs from a family member, only 40% do so. It is time for the public to be made aware of these debates, and that what we are doing is the right thing to do.”

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