Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death.

Details

Serval ID
serval:BIB_B9F46CE081FB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death.
Journal
American journal of transplantation
Author(s)
Dalle Ave A.L., Shaw D.M., Bernat J.L.
ISSN
1600-6143 (Electronic)
ISSN-L
1600-6135
Publication state
Published
Issued date
08/2016
Peer-reviewed
Oui
Volume
16
Number
8
Pages
2293-2299
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The use of donor extracorporeal membrane oxygenation (ECMO) to improve graft outcomes by some controlled donation after circulatory determination of death (cDCDD) programs raises ethical issues. We reviewed cDCDD protocols using ECMO and the relevant ethics literature to analyze these issues. It is not obvious that ECMO in cDCDD improves graft outcomes. In our opinion, ECMO implemented before death can interfere with end-of-life care and damage bodily integrity. By restoring systemic circulation, ECMO risks invalidating the preceding declaration of death if brain and cardiac perfusion is not adequately excluded because of malfunction or misplacement of the supradiaphragmatic aortic occlusion balloon. The use of ECMO is not compatible with the acronym DCDD because circulation is restored after the determination of death. Because of these deficiencies, we concluded that other techniques are preferable, such as rapid recovery or in situ cold infusion. If ECMO is performed, it requires a specific informed consent and transparency.

Keywords
Brain Death, Extracorporeal Membrane Oxygenation/ethics, Graft Rejection/prevention & control, Humans, Informed Consent, Organ Preservation, Organ Transplantation, Tissue Donors/supply & distribution, Tissue and Organ Procurement/methods, artificial organs/support devices, donors and donation: donation after circulatory death (DCD), ethics and public policy, organ transplantation in general
Pubmed
Web of science
Create date
29/03/2016 13:32
Last modification date
20/09/2019 5:26
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