An analysis of heart donation after circulatory determination of death

Journal of Medical Ethics
Anne L Dalle AveJames L Bernat

Abstract

Heart donation after circulatory determination of death (DCDD) has provoked ethical debate focused primarily on whether heart DCDD donors are dead when death is declared and when organs are procured. We rigorously analyse whether four heart DCDD programmes (Cape Town, Denver, Australia, Cambridge) respect the dead donor rule (DDR), according to six criteria of death: irreversible cessation of all bodily cells function (or organs), irreversible cessation of heart function, irreversible cessation of circulation, permanent cessation of circulation, irreversible cessation of brain function and permanent cessation of brain function. Only death criteria based on permanency are compatible with the DDR under two conditions: (1) a minimum stand-off period of 5 min to ensure that autoresuscitation is impossible and that all brain functions have been lost and (2) no medical intervention is undertaken that might resume bodily or brain circulation. By our analysis, only the Australia heart DCDD programme using a stand-off period of 5 min respects the DDR when the criteria of death are based on permanency.

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Citations

Mar 18, 2016·Journal of Medical Ethics·Michael Nair-Collins, Franklin G Miller
Mar 5, 2016·Journal of Medical Ethics·Robert Truog
Apr 6, 2017·Current Opinion in Organ Transplantation·Kumud K DhitalPeter S Macdonald
Oct 20, 2017·Current Opinion in Organ Transplantation·Andrew McGeePaul Murphy
Apr 5, 2019·Theoretical Medicine and Bioethics·David S Oderberg
Jan 11, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Alex ManaraChristopher J E Watson
Jan 4, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Alexis F TurgeonFrançois Lauzier
Feb 24, 2017·BMC Medical Ethics·Anne L Dalle Ave, James L Bernat
Jan 1, 2016·Journal of Intensive Care Medicine·Anne L Dalle Ave, James L Bernat
Mar 18, 2017·Current Opinion in Cardiology·Reema HasanDaniel Goldstein
Nov 20, 2020·Transplantation·Laura Anguela-CalvetEva Oliver-Juan

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