Normothermic Regional Perfusion Does Not Hasten Death

A novel method of organ donation after circulatory death called normothermic regional perfusion (NRP) could mitigate the organ shortage crisis and lead to superior outcomes for organ recipients. In NRP, following a pronouncement of death by circulatory criteria, arteries leading to the brain are occluded and abdominal circulation is reinitiated in situ. A prominent objection to NRP maintains that it kills the donor since the arterial occlusion prevents blood from reaching the brain after circulation is reinitiated. Proponents of this objection recommend that transplant surgeons use normothermic machine perfusion (NMP) instead of NRP. In NMP, organs are removed from the donor's body and perfused by machines using nutrient-enriched donor blood following the circulatory determination of death. Here I argue that if NRP kills the donor, then so does NMP. But I argue that features of NMP that clear the practice of the charge of impermissible homicide are also present in NRP. Like NMP, NRP at most preemptively causes the donor to die at the same time he would have died otherwise. It does not hasten death.