Normothermic regional perfusion: Ethical issues in thoracic organ donation

Cardiothoracic Ethics Forum

doi:10.1016/j.jtcvs.2022.01.018

Normothermic regional perfusion: Ethical issues in thoracic organ donation

Cardiothoracic Ethics Forum

Department of Cardiothoracic Surgery

Resultado de la investigación: Editorial › revisión exhaustiva

7 Citas (Scopus)

Idioma original	English (US)
Páginas (desde-hasta)	147-154
Número de páginas	8
Publicación	Journal of Thoracic and Cardiovascular Surgery
Volumen	164
N.º	1
DOI	https://doi.org/10.1016/j.jtcvs.2022.01.018
Estado	Published - jul 2022

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.jtcvs.2022.01.018

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@article{1f52fcaf3376403db9c333dc6274e852,

title = "Normothermic regional perfusion: Ethical issues in thoracic organ donation",

keywords = "donation after circulatory-determined death, ethics, heart transplantation",

author = "{Cardiothoracic Ethics Forum} and Entwistle, {John W.} and Drake, {Daniel H.} and Fenton, {Kathleen N.} and Smith, {Michael A.} and Sade, {Robert M.} and Leah Backhus and David Blitzer and Carpenter, {Andrea J.} and Cohen, {Robbin G.} and Thomas D'Amico and Joseph Dearani and Matthias Loebe and Luc, {Jessica G.Y.} and McKneally, {Martin F.} and Millikan, {Scott J.} and Moffatt-Bruce, {Susan D.} and Sudish Murthy and Nason, {Katie S.} and Allan Pickens and Sunil Prasad and Romano, {Jennifer C.} and Silvestry, {Scott C.} and Zwischenberger, {Joseph B.}",

note = "Funding Information: TA-NRP protocols require prevention of cerebral circulation to ensure permanent absence of brain function. Although it is relatively easy to prevent major vessel perfusion of the brain using ligation or balloon occlusion, collateral sources of blood flow might provide some degree of brain perfusion. Several methods have been advocated to ensure complete loss of brain circulation during TA-NRP procedures, including free drainage of aortic arch vessels to atmospheric or negative pressure, thus allowing collateral vessels, such as vertebral or spinal arteries, to drain to atmospheric pressure.13 Total absence of brain perfusion has not yet been proven definitively, but in the study from Manara and colleagues13 of 3 patients, persisting drainage of blood from the open ends of the arch vessels provides support for the presumption that ischemia is complete. Several possible means to substantiate absence of brain perfusion exist, but have not yet been systematically investigated in TA-NRP.28 For that reason, TA-NRP in the United States should be done under research protocols that include verification that perfusion of the brain stem is absent.",

year = "2022",

month = jul,

doi = "10.1016/j.jtcvs.2022.01.018",

language = "English (US)",

volume = "164",

pages = "147--154",

journal = "Journal of Thoracic and Cardiovascular Surgery",

issn = "0022-5223",

publisher = "Mosby Inc.",

number = "1",

}

TY - JOUR

T1 - Normothermic regional perfusion

T2 - Ethical issues in thoracic organ donation

AU - Cardiothoracic Ethics Forum

AU - Entwistle, John W.

AU - Drake, Daniel H.

AU - Fenton, Kathleen N.

AU - Smith, Michael A.

AU - Sade, Robert M.

AU - Backhus, Leah

AU - Blitzer, David

AU - Carpenter, Andrea J.

AU - Cohen, Robbin G.

AU - D'Amico, Thomas

AU - Dearani, Joseph

AU - Loebe, Matthias

AU - Luc, Jessica G.Y.

AU - McKneally, Martin F.

AU - Millikan, Scott J.

AU - Moffatt-Bruce, Susan D.

AU - Murthy, Sudish

AU - Nason, Katie S.

AU - Pickens, Allan

AU - Prasad, Sunil

AU - Romano, Jennifer C.

AU - Silvestry, Scott C.

AU - Zwischenberger, Joseph B.

N1 - Funding Information: TA-NRP protocols require prevention of cerebral circulation to ensure permanent absence of brain function. Although it is relatively easy to prevent major vessel perfusion of the brain using ligation or balloon occlusion, collateral sources of blood flow might provide some degree of brain perfusion. Several methods have been advocated to ensure complete loss of brain circulation during TA-NRP procedures, including free drainage of aortic arch vessels to atmospheric or negative pressure, thus allowing collateral vessels, such as vertebral or spinal arteries, to drain to atmospheric pressure.13 Total absence of brain perfusion has not yet been proven definitively, but in the study from Manara and colleagues13 of 3 patients, persisting drainage of blood from the open ends of the arch vessels provides support for the presumption that ischemia is complete. Several possible means to substantiate absence of brain perfusion exist, but have not yet been systematically investigated in TA-NRP.28 For that reason, TA-NRP in the United States should be done under research protocols that include verification that perfusion of the brain stem is absent.

PY - 2022/7

Y1 - 2022/7

KW - donation after circulatory-determined death

KW - ethics

KW - heart transplantation

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DO - 10.1016/j.jtcvs.2022.01.018

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SN - 0022-5223

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JO - Journal of Thoracic and Cardiovascular Surgery

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