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Introduction: Organ Donation and Death from Unexpected Circulatory Arrest: Engaging the Recommendations of the Institute of Medicine

Published online by Cambridge University Press:  01 January 2021

Extract

This symposium explores the boldest recommendation of the Institute of Medicine’s (IOM) Committee on Increasing Rates of Organ Donation (hereafter Committee), namely, the recommendation that the U.S. consider a new population of potential donors. In its 2006 report, Organ Donation: Opportunities for Action, the committee recommended pilot programs in socalled “uncontrolled” donation after a circulatory determination of death (uDCD). Potential uDCD donors have died from an unexpected loss of circulation, either due to sudden cardiac arrest or excessive blood loss following traumatic injury. Because circulation is lost before death is determined and long before organ procurement could begin, potentially transplantable organs will die from oxygen starvation (warm ischemia) unless they are quickly preserved by cooling or other means.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2008

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References

Childress, J. F. and Liverman, C.T., eds., Organ Donation: Opportunities for Action (Washington, D.C.: National Academies Press, 2006): at 154. The IOM Committee expressed concerns about the term “uncontrolled” DCD, noting that it is the patient's death that is uncontrolled — or better, “unexpect” — not the organ donation, which proceeds according to protocol.Google Scholar
Institute of Medicine, Non-Heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement (Washington, D.C.: National Academy Press, 1997); Institute of Medicine, Non-Heart-Beating Organ Transplantation. Practice and Protocols (Washington, D.C.: National Academy Press, 2000).Google Scholar
Bernat, J. L., D'Alessandro, A. M. and Port, F. K. et al. “Report of a National Conference on Donation after Cardiac Death,” American Journal of Transplantation 6, no. 2 (2006): 281–91.CrossRefGoogle Scholar
See Childress, and Liverman, , supra note 1, available at <http://www.iom.edu/?id=25781> (last visited October 1, 2008), under “Statement of Task.”+(last+visited+October+1,+2008),+under+“Statement+of+Task.”>Google Scholar
Childress, and Liverman, , supra note 1, at 157.Google Scholar
Id., at 152153.Google Scholar
Id., at 157.Google Scholar
Id., at 153.Google Scholar
Id., at 157.Google Scholar
Id., at 154.Google Scholar
The 1997 report on DCD reviewed arguments for and against routine organ preservation and concluded that “[p]erhaps further study and discussion should be pursued.” See Institute of Medcine, 1997, supra note 1, at 55. For the AMA position see the Code of Medical Ethics at E-2.157, availiable at <http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/HnE/E-2.157.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/HnE/E-1.02.HTM&nxt_pol=policyfiles/HnE/E-2.01.HTM&> (last visited October 1, 2008).+(last+visited+October+1,+2008).>Google Scholar
Sanchez-Fructuoso, A., Giorgi, M. and Barrientos, A., “Kidney Transplantation from Non-Heart-Beating Donors: A Spanish View,” Transplantation Reviews 21, no. 4 (2007): 249254.CrossRefGoogle Scholar
Bonnie, R. J., Wright, S. and Dineen, K., “Legal Authority to Preserve Organs in Cases of Uncontrolled Cardiac Death: Preserving Family Choice,” Journal of Law, Medicine & Ethics 36, no. 3 (2008): 741751.CrossRefGoogle Scholar
Borry, P., Van Reusel, W., Roels, L. and Schotsman, P., “Donation after Uncontrolled Cardiac Death (DCD): A Review of the Debate from a European Perspective,” Journal of Law, Medicine & Ethics 36, no. 3 (2008): 752759.CrossRefGoogle Scholar
Childress, J. F., “Organ Donation after Cardiac Determination of Death: Lessons and Unresolved Controversies,” Journal of Law, Medicine & Ethics 36, no. 3 (2008): 766771.CrossRefGoogle Scholar