@article{3b38e93d13ea4583bed848331fa3be90,
title = "Normothermic Regional Perfusion: Ethical Issues in Thoracic Organ Donation",
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.athoracsur.2022.01.058",
language = "English (US)",
volume = "114",
pages = "44--51",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier Inc.",
number = "1",
}