An Official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death
An Official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death
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DOI：
10.1164/rccm.201304-0714st
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发表时间：
2013-07-01
影响因子：
24.7
通讯作者：
Halpern, Scott D.
中科院分区：
文献类型：
--
作者：
Gries, Cynthia J.;White, Douglas B.;Halpern, Scott D.
理由：循环确定死亡（DCDD）后的捐赠有可能增加可用于移植的器官数量。由于潜在捐赠者的同意和管理必须在死亡之前进行，因此DCDD提出了独特的伦理和政策问题。目标：制定与重症监护和移植利益相关者相关的成人和儿童DCDD的伦理和卫生政策声明。方法：召集了一个多学科的利益相关者小组来制定一份伦理和卫生政策声明。该小组由来自美国胸科学会、重症医学学会、国际心肺移植学会、器官采购组织协会和器官共享联合网络的代表组成。小组审查了文献，讨论了重要的伦理和卫生政策考虑，并制定了利益攸关方决策的指导框架。结果：建立了一个指导伦理和卫生政策声明的框架，其中涉及同意程序、死前和死后干预、死亡的确定、提供临终关怀和儿科DCDD。结论：本声明中提供的信息是基于当前的证据、经验和临床原理。新的临床研究以及新技术的发展和传播最终将需要对本声明进行更新。
Rationale: Donation after circulatory determination of death ( DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues. Objectives: To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders.Methods: A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and developed a guiding framework for decision making by stakeholders.Results: A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD.Conclusions: The information presented in this Statement is based on the current evidence, experience, and clinical rationale. New clinical research and the development and dissemination of new technologies will eventually necessitate an update of this Statement.