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

ining; 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Surrogates should be informed during the consent process regarding: (1) how and where life-sustaining therapies will be withdrawn, (2) the amount of time they can spend with their loved one post mortem and (3) the possibility that the patient may not die within the time interval necessary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.

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

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