Annals of Neurology,
Journal Year:
2024,
Volume and Issue:
95(6), P. 1035 - 1039
Published: March 19, 2024
Normothermic
regional
perfusion
(NRP)
has
recently
been
used
to
augment
organ
donation
after
circulatory
death
(DCD)
improve
the
quantity
and
quality
of
transplantable
organs.
In
DCD‐NRP,
withdrawal
life‐sustaining
therapies
cardiopulmonary
arrest,
patients
are
cannulated
onto
extracorporeal
membrane
oxygenation
reestablish
blood
flow
targeted
organs
including
heart.
During
this
process,
aortic
arch
vessels
ligated
restrict
cerebral
flow.
We
review
ethical
challenges
whether
brain
is
sufficiently
reperfused
through
collateral
circulation
allow
reemergence
consciousness
or
pain
perception,
resumption
cardiac
activity
nullifies
patient's
prior
determination,
specific
authorization
for
DCD‐NRP
required.
ANN
NEUROL
2024;95:1035–1039
Annals of Internal Medicine,
Journal Year:
2023,
Volume and Issue:
176(9), P. 1245 - 1250
Published: Sept. 1, 2023
The
determination
of
a
patient's
death
is
considerable
medical
and
ethical
significance.
Death
biological
concept
with
social
implications.
Acting
honesty,
transparency,
respect,
integrity
critical
to
trust
in
the
patient-physician
relationship,
profession,
life
death.
Over
time,
cases
about
have
raised
questions
that
need
be
addressed.
This
American
College
Physicians
position
paper
addresses
current
controversies
supports
clarification
Uniform
Determination
Act;
maintaining
2
independent
standards
determining
death,
cardiorespiratory
neurologic;
retaining
whole
brain
standard;
aligning
testing
standards;
keeping
issues
separate
from
organ
transplantation;
reaffirming
importance
role
dead
donor
rule;
engaging
educational
efforts
for
health
professionals,
patients,
public
on
these
issues.
should
advocate
policies
practices
are
consistent
profession's
fundamental
timeless
commitment
individual
patients
public.
Current Opinion in Organ Transplantation,
Journal Year:
2022,
Volume and Issue:
unknown
Published: Nov. 18, 2022
Purpose
of
review
This
is
intended
to
provide
an
update
on
the
logistics,
technique,
and
outcomes
associated
with
normothermic
regional
perfusion
(NRP),
as
well
a
discussion
ethical
issues.
Recent
findings
There
has
been
renewed
interest
in
utilizing
NRP
increase
quality
availability
organs
from
donation
after
circulatory
death
(DCD)
donors.
Our
institution
increasing
experience
thoraco-abdominal
(TA-NRP)
controlled
DCD
donors
(cDCD),
whereas
abdominal
(A-NRP)
used
success
both
cDCD
uncontrolled
(uDCD).
evidence
that
can
be
conducted
practical
cost-efficient
manner,
organ
yield
may
better
than
standard
direct
procurement
(DPP).
Summary
increasingly
successful
will
likely
prove
superior
method
for
recovery.
However,
before
TA-NRP
widely
accepted
debate
surrounding
this
technique
must
settled.
Video
abstract
http://links.lww.com/COOT/A11
Annals of Neurology,
Journal Year:
2024,
Volume and Issue:
95(6), P. 1035 - 1039
Published: March 19, 2024
Normothermic
regional
perfusion
(NRP)
has
recently
been
used
to
augment
organ
donation
after
circulatory
death
(DCD)
improve
the
quantity
and
quality
of
transplantable
organs.
In
DCD‐NRP,
withdrawal
life‐sustaining
therapies
cardiopulmonary
arrest,
patients
are
cannulated
onto
extracorporeal
membrane
oxygenation
reestablish
blood
flow
targeted
organs
including
heart.
During
this
process,
aortic
arch
vessels
ligated
restrict
cerebral
flow.
We
review
ethical
challenges
whether
brain
is
sufficiently
reperfused
through
collateral
circulation
allow
reemergence
consciousness
or
pain
perception,
resumption
cardiac
activity
nullifies
patient's
prior
determination,
specific
authorization
for
DCD‐NRP
required.
ANN
NEUROL
2024;95:1035–1039
