cDCDD-NRP is consistent with US legal standards for determining death

Area of Science:

• Transplantation Medicine
• Bioethics
• Legal Medicine

Background:

• Donation after circulatory determination of death (DCDD) has significantly improved organ donation rates in the US.
• Existing legal frameworks support DCDD within end-of-life care decisions.
• Warm ischemic time negatively impacts organ viability post-mortem.

Purpose of the Study:

• To present the rationale for controlled DCDD using normothermic regional perfusion (cDCDD-NRP).
• To demonstrate that cDCDD-NRP is consistent with current US organ donation legal frameworks.
• To advocate for the continued use of the Uniform Determination of Death Act without modification.

Main Methods:

• The study is a viewpoint discussing the application of cDCDD-NRP.
• It analyzes the compatibility of cDCDD-NRP with existing US organ donation laws.
• It reviews the benefits of NRP in mitigating warm ischemic time.

Main Results:

• cDCDD-NRP allows for the recovery of additional organs, including the heart.
• Perfusion via NRP limits the detrimental effects of warm ischemic time.
• The cDCDD-NRP protocol is deemed consistent with the established legal framework for organ donation.

Conclusions:

• cDCDD-NRP enhances organ recovery and supports the maximization of donation decisions.
• No changes are recommended for the Uniform Determination of Death Act.
• This approach aligns with ethical considerations in end-of-life organ donation.