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- Title
Beyond the Final Heartbeat: Neurological Perspectives on Normothermic Regional Perfusion for Organ Donation after Circulatory Death.
- Authors
Kirschen, Matthew P.; Lewis, Ariane; Rubin, Michael A.; Varelas, Panayiotis N.; Greer, David M.
- Abstract
Normothermic regional perfusion (NRP) has recently been used to augment organ donation after circulatory death (DCD) to improve the quantity and quality of transplantable organs. In DCD‐NRP, after withdrawal of life‐sustaining therapies and cardiopulmonary arrest, patients are cannulated onto extracorporeal membrane oxygenation to reestablish blood flow to targeted organs including the heart. During this process, aortic arch vessels are ligated to restrict cerebral blood flow. We review ethical challenges including whether the brain is sufficiently reperfused through collateral circulation to allow reemergence of consciousness or pain perception, whether resumption of cardiac activity nullifies the patient's prior death determination, and whether specific authorization for DCD‐NRP is required. ANN NEUROL 2024;95:1035–1039
- Subjects
ISOLATION perfusion; ORGAN donation; CEREBRAL circulation; COLLATERAL circulation; BLOOD flow
- Publication
Annals of Neurology, 2024, Vol 95, Issue 6, p1035
- ISSN
0364-5134
- Publication type
Article
- DOI
10.1002/ana.26926