Heart transplantation after the circulatory death; The ethical dilemma

Area of Science:

• Medical Ethics
• Transplantation Medicine
• Organ Donation

Background:

• Donors after brain death (DBD) have historically been the primary source for organ transplantation due to optimal organ perfusion.
• An increasing gap between organ demand and supply has led to a rise in the utilization of donors after circulatory death (DCDD) globally.
• While kidneys, liver, and lungs are routinely transplanted from DCDDs, heart transplantation from this donor pool is a recent development facing ethical scrutiny.

Purpose of the Study:

• To differentiate between brain death donors (DBD) and circulatory death donors (DCDD) in organ procurement.
• To explore the ethical implications of the dead-donor rule on the organ donation pool.
• To analyze the determinants of death in relation to organ donation methods.

Main Methods:

• Literature review comparing DBD and DCDD donation protocols.
• Analysis of ethical considerations surrounding the declaration of death in DCDD.
• Categorization of death determination criteria for different donor types.

Main Results:

• The study differentiates the physiological and ethical considerations between DBD and DCDD.
• It highlights the ethical debate concerning the precise moment of death declaration for DCDD organ procurement.
• The review examines the impact of these definitions on the availability of organs for transplantation.

Conclusions:

• The increasing reliance on DCDDs necessitates a clear understanding of circulatory death criteria and ethical frameworks.
• Addressing the ethical scrutiny surrounding DCDD organ transplantation is crucial for expanding the organ donor pool.
• Distinguishing between DBD and DCDD methods is essential for ethical and effective organ donation practices.