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:10/13/2017)... ... October 13, 2017 , ... ... Randall, PharmD ‘17, and Jennifer Huggins, PharmD ’17, along with clinical associate ... primary prevention of cardiovascular diseases during the 15th Annual Women’s Health Conference. ...
(Date:10/13/2017)... , ... October 13, 2017 , ... The Visiting Nurse ... Market. Featuring a collection of specialty vendors and unique items from across the nation, ... quality-focused health and wellness services offered by the VNA. The boutique will be ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, ... lowdown on sciatica in a new episode of "Success Files," which is an ... and innovation and investigates each subject in-depth with passion and integrity. , Sciatica ...
(Date:10/12/2017)... ... October 12, 2017 , ... First Healthcare Compliance ... management, will showcase a range of technology and learning solutions at the 68th ... and Expo to be held October 14–18, 2017 at the Mandalay Bay Resort ...
(Date:10/12/2017)... ... October 12, 2017 , ... IsoComforter, Inc. ( https://isocomforter.com ... introduction of an innovative new design of the shoulder pad. The shoulder pad ... comfort while controlling your pain while using cold therapy. By utilizing ice and water ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... Oct. 2, 2017 The Rebound mobile app is ... to reverse the tide of prescription drug addiction. The app ... medicine intake and stepping down their dosage in a safe, ... in December 2017; the first 100,000 people to sign up ... http://www.rebound-solution.com/ ...
(Date:9/27/2017)... 27, 2017  Commended for their devotion to personalized service, ... as number one in the South Florida Business Journal,s 50 ... 5000 yearly list, the national specialty pharmacy has found its ... will soon be honored by SFBJ as the 2017 ... Set to receive his award in October, Bardisa said ...
(Date:9/25/2017)... PROVIDENCE, R.I. , Sept. 25, 2017 /PRNewswire/ ... immunogenicity assessment, vaccine design, and immune-engineering today announced ... focused on the development of personalized therapeutic cancer ... and has provided exclusive access to enabling technologies ... MSc Eng., MBA will lead EpiVax Oncology as ...
Breaking Medicine Technology: