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

cDCDD-NRP is consistent with US legal standards for determining death.
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DOI:
10.1111/ajt.17083
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发表时间:
2022-10
期刊:
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
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在过去的十年中,在一个既定的法律框架内,在循环确定死亡(DCDD)后的捐赠增加了美国的器官捐赠率,这符合并支持个人和家庭在临终关怀背景下关于器官捐赠的决定。一项新的应用,利用胸腹恒温区域灌注(NRP)协议(cDCDD - NRP)的控制DCDD捐赠,提供了通过恢复包括心脏在内的额外移植器官来最大化捐赠决策的机会,并通过在宣布循环死亡后原位灌注器官来限制热缺血时间的有害影响。从这个角度来看,我们阐述了为什么cDCDD - NRP在美国现有的器官捐赠法律框架内是一致的,并建议不修改《统一死亡决定法》。由于《统一死亡判定法》(UDDA)下的死亡判定不能在法律上被逆转,也不能被捐赠者家庭或器官恢复专业人员通过捐赠过程(包括使用恒温区域灌注)影响,因此修改UDDA是不必要的,也是不明智的。
Donation after circulatory determination of death (DCDD) has increased organ donation rates in the US over the past decade within an established legal framework, which is consistent with and supports individual and family decisions regarding organ donation in the context of end‐of‐life care. A new application, controlled DCDD donation utilizing thoracoabdominal normothermic regional perfusion (NRP) protocols (cDCDD‐NRP), provides the opportunity to maximize a donation decision by recovering additional organs for transplant, including the heart, and to limit the detrimental impact of warm ischemic time by perfusing organs in situ following the declaration of circulatory death. In this viewpoint, we narrate our rationale for why cDCDD‐NRP is consistent within the existing legal framework for organ donation in the United States and recommend no changes to the Uniform Determination of Death Act. Since a determination of death under the Uniform Determination of Death Act (UDDA) cannot legally be reversed or affected by donor families or organ recovery professionals through the donation process, inclusive of the use of normothermic regional perfusion, revising the UDDA is unnecessary and ill‐advised.
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