Navigation Links
ATS publishes statement on organ donation after circulatory determination of death
Date:6/30/2013

The American Thoracic Society has released an official statement on the ethical and health policy considerations surrounding adult and pediatric controlled organ donation after circulatory determination of death (DCDD), the recovery of organs after cessation of circulation from patients with severe neurological, neuromuscular or pulmonary disease for whom decisions are made to forego additional life-prolonging treatments.

The ATS developed the statement with input from the Society of Critical Care Medicine, the International Society for Heart and Lung Transplantation, the Association of Organ Procurement Organizations, and the United Network of Organ Sharing.

The statement appears in the July 1, 2013, issue of the American Journal of Respiratory and Critical Care Medicine.

"The recovery of viable organs must be performed with maximum respect for dying patients and their families," said Cynthia Gries, MD, MSc, assistant professor of medicine and clinical translational sciences in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pittsburgh Medical Center and chair of the committee that drafted the statement. "With that goal in mind, we developed a framework to help guide the various stakeholders involved in the DCDD process."

Recommendations in the statement include the following:

Consent


  • When patients themselves have consented to organ donation, hospital critical care and organ procurement organization (OPO) representatives should respect the patient's decision and provide this information to surrogate decision makers.
  • After clinicians lead discussions with patients or surrogates about the decisions to withdraw life-sustaining therapies, discussions about DCDD should proceed promptly and be coordinated jointly by clinicians and OPO representatives.
  • Consent for DCDD should be obtained by individuals with appropriate experience and training; these individuals' organizational affiliations should be disclosed clearly.

Interventions


  • Use of ante-mortem interventions and medications should be disclosed to surrogates at the time of consent and identified as being administered solely for the purpose of organ donation.
  • Ante-mortem interventions are ethically appropriate if they contribute to good transplant outcomes and have a low chance of harming the prospective donor.
  • Post-mortem donor management interventions that may stimulate physiologic functions require further analysis of their clinical usefulness and ethical merit.

Determination of death


  • Death can be declared after the cessation of circulation and respiratory function for 2 minutes.
  • Information about how death will be determined should be provided to the patient or the surrogates.

End-of-life care


  • Surrogates should be informed during the consent process regarding: (1) how and where life-sustaining therapies will be withdrawn, (2) the amount of time they can spend with their loved one post mortem and (3) the possibility that the patient may not die within the time interval necessary for DCDD to occur.
  • Hospitals that participate in DCDD should ensure that experienced personnel with competency in palliative care are available to participate in end-of-life care if needed.
  • Hospitals that participate in DCDD should have a clear policy regarding how and where patients will be cared for if they do not expire within the time interval acceptable for donation.

Pediatric DCDD


  • Although pediatric patients cannot provide consent to their own donation, consent of the parent or of another legal surrogate can be used.
  • The ethical principles related to consent, intervention, declaration of death and end-of-life care in pediatric DCDD patients are similar to those for adults.

"Increased use of DCDD organs could have a substantial impact on the chronic shortage of donor organs available for transplantation, but as the consent and management of potential DCDD donors occurs before death, it raises a number of important ethical and policy issues," Dr. Gries said. "This statement, which incorporates input from a number of critical care and transplant societies, addresses those issues."


'/>"/>

Contact: Nathaniel Dunford
ndunford@thoracic.org
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. Vein Therapy News Magazine Publishes Laser Facelift Article by Dr. Robin Fleck
2. Zane Benefits Publishes New Information on the Cost of Employer-Sponsored Health Care in 2013
3. Zane Benefits Publishes New Information on the Montana Health Insurance Exchange
4. Cellars Wine Club Publishes Article Answering Wine Club Questions
5. Zane Benefits Publishes New Information on Health Care Reform Compliance
6. TechReviews Publishes Latest Detailed Reviews for Best Electric Toothbrushes
7. Zane Benefits Publishes New Information on Individual Health Insurance Marketplaces
8. Zane Benefits Publishes New Information on Health Reimbursement Medical Plans
9. Zane Benefits Publishes New Information on the Wisconsin Health Insurance Exchange
10. Neurosurgery publishes findings of 3 important studies in June issue
11. Maturitas publishes 2013 update on diagnosis and management of osteoporosis
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/24/2017)... ... , ... Dr. Alan I. Benvenisty, MD is dual board certified in general ... for his distinguished expertise and experience in the diagnosis and treatment of vascular diseases. ... renovascular disease and aortic aneurysm . He is known for his minimally invasive ...
(Date:5/24/2017)... , ... May 24, 2017 , ... ... medical image management and interpretation, has received U.S. Food and Drug Administration (FDA) ... is a web-based, scalable and secure cloud platform for medical image management. At ...
(Date:5/24/2017)... ... May 24, 2017 , ... Dr. Manju R. Kejriwal, a ... orthodontics, with or without a referral. Dr. Kejriwal understands the emotional and financial ... clear braces in Cincinnati, OH. Patients no longer need to feel the esthetic effects ...
(Date:5/24/2017)... ... May 24, 2017 , ... STATEMENT OPPOSING ... vehemently opposed to Donald Trump’s budget, “A New Foundation for American Greatness—President's Budget ... demonizes the poor, marginalizes underserved populations, undermines productivity, and destroys the social safety ...
(Date:5/24/2017)... , ... May 24, 2017 , ... ... completed Course II of the HP3 (High-Performance Periodontal Practice) continuing education (CE) series. ... the latest advancements in his field by attending numerous CE courses each year. ...
Breaking Medicine News(10 mins):
(Date:5/6/2017)... 2017  May is Stroke Awareness Month and Omron ... important methods to prevent a stroke: monitor and manage ... Control and Prevention, undetected and uncontrolled hypertension is a ... global leader in personal heart health technology, recently evolved ... attack and stroke and is advancing a national public ...
(Date:5/4/2017)... Clarius Mobile Health, a digital healthcare ... this week at the American Congress of Obstetricians ... San Diego, CA from May ... perfect tool for clinicians to easily confirm pregnancy, ... pregnancy-related complications like ectopic pregnancy and placenta previa," ...
(Date:5/4/2017)...   BioLife Solutions , Inc. (NASDAQ: ... proprietary clinical grade hypothermic storage and ... announced that the Company,s first quarter 2017 financial results ... 11, 2017, and that the Company will host a ... that afternoon. Management will provide an overview of the ...
Breaking Medicine Technology: