Normothermic regional perfusion in the United States: A call for improved data collection

The Journal of Heart and Lung Transplantation, Год журнала: 2024, Номер 43(7), С. 1196 - 1197

Опубликована: Март 21, 2024

Язык: Английский

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Ethical Issues in Normothermic Regional Perfusion in Controlled Organ Donation After Determination of Death by Circulatory Criteria: A Scoping Review

Transplantation, Год журнала: 2024, Номер unknown

Опубликована: Авг. 28, 2024

Normothermic regional perfusion (NRP) is a surgical technique that can improve the quality and number of organs recovered for donation after determination death by circulatory criteria. Despite its promise, adoption NRP has been hindered because unresolved ethical issues. To inform stakeholders, this scoping review provides an impartial overview major controversies surrounding NRP. We undertook according to modified 5-step methodology proposed Arksey O’Malley. Publications were retrieved through MEDLINE Embase. Gray literature was sourced from Canadian organ organizations, English-language organization websites, our research networks. Three reviewers independently screened all documents inclusion, extracted data, participated in content analysis. Disagreements resolved consensus meetings. Seventy-one substantively engaging with issues included full-text identified 6 themes encompassing range overlapping debates: (1) compatibility dead donor rule, injunction recovery cannot cause death, (2) risk harm posed NRP, (3) uncertainties regarding consent requirements (4) risks stakeholder trust (5) implications justice, (6) NRP’s potential benefits stakeholders. found no agreement on permissibility However, some debates may be additional empirical study. As decision-makers contemplate it critical address facing ensure deceased transplantation systems preserved.

Язык: Английский

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The Ethics of Heart Donation After the Circulatory Determination of Death: Gaps in Knowledge and Research Opportunities

Bioethics, Год журнала: 2025, Номер unknown

Опубликована: Апрель 25, 2025

ABSTRACT In 2023, the National Heart, Lung, and Blood Institute (NHLBI) organized a workshop to identify research gap areas in organ donation after circulatory determination of death (DCDD). We present findings DCDD ethics working group. Heart DCDD, as all may disrupt optimal end‐of‐life care. Irrespective donation, opportunities include identifying which processes withdrawal life‐sustaining therapy offer optimum patient comfort, how best ensure comfort at end life, better understand patients' preferences for Whether heart breaches Dead Donor Rule (DDR) depends on its interpretation, validity rationale death, protocol used. Further could clarify interpretation DDR, concept time cessation brain function ensures that is beyond neuro‐cognitive harm, implications thoracoabdominal normothermic regional perfusion functions, type consent level information required different techniques.

Язык: Английский

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Normothermic Regional Perfusion in Pediatric Organ Recovery—Guidelines for Its Ethical Implementation

Pediatric Transplantation, Год журнала: 2025, Номер 29(5)

Опубликована: Май 30, 2025

ABSTRACT The scarcity of transplantable organs has led to the development normothermic regional perfusion (NRP) enhance organ viability and supply. While NRP offers promise increase quality quantity organs, its implementation raises significant ethical concerns regarding Dead Donor Rule (DDR), consent/authorization, physician participation. These are further magnified in pediatric donation given such patients' increased vulnerability lack decision‐making authority. arguments continue play out literature, several OPOs US perform requesting institutions implement this practice. As ethicists, our aim is create guidelines for donors. We highlight challenges DDR, discuss requirements informed consent, outline a thoughtful approach engaging with families during crises, address conscientious objections clinicians who morally apprehensive about participating NRP. recommend collaboration hospital/organizational leadership, transplant programs, procurement organizations, clinical ethicists collaboratively plan these controversies at institutional level. Use pre‐NRP checklist may help ensure that all potential donor patients treated respect fully process there sufficient education support participate If collaborate guidelines, they will honor donors their without negatively impacting public trust donation, supply viability, ultimately improve outcomes recipients.

Язык: Английский

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AI-Supported Pneumonia Diagnosis: Performance of Deep Learning Models and Synthetic Data Generation

Опубликована: Сен. 25, 2024

Язык: Английский

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The Unified Brain-Based Determination of Death: Conceptual Challenges

The American Journal of Bioethics, Год журнала: 2024, Номер 24(6), С. 57 - 60

Опубликована: Июнь 2, 2024

Язык: Английский

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Medicine, Bioethics, and the Search for Truth: Does “Declaring” Death Make It So?

The American Journal of Bioethics, Год журнала: 2024, Номер 24(6), С. 82 - 84

Опубликована: Июнь 2, 2024

Язык: Английский

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