To Transplant or Not, the Ethical Dilemma: A Case Report of Pediatric Heart Transplantation

Determination of organ transplant requires a layered approach, considering ethical principles, patient status, and projected outcomes. In this case, we present a difficult question of how to proceed if a patient anesthetized for heart transplantation experiences cardiac arrest in the operating room (OR) before establishment of cardiopulmonary bypass (CPB). The Organ Procurement and Transplant Network (OPTN), United Network of Organ Sharing (UNOS), and regulatory requirements fail to provide specific guidance. We explore various considerations involved in deciding whether to proceed, guided by ethical frameworks that recognize recipient and donor rights and broader societal aspects of transplantation.