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Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 3693544
Author(s) Dalle Ave, Anne; Shaw, David; Bernat, James
Author(s) at UniBasel Shaw, David
Year 2016
Title Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death
Journal American Journal of Transplantation
Volume 16
Number 8
Pages / Article-Number 2293-9
Abstract The use of donor extracorporeal membrane oxygenation (ECMO) to improve graft outcomes by some controlled donation after circulatory determination of death (cDCDD) programs raises ethical issues. We reviewed cDCDD protocols using ECMO and the relevant ethics literature to analyze these issues. It is not obvious that ECMO in cDCDD improves graft outcomes. In our opinion, ECMO implemented before death can interfere with end-of-life care and damage bodily integrity. By restoring systemic circulation, ECMO risks invalidating the preceding declaration of death if brain and cardiac perfusion is not adequately excluded because of malfunction or misplacement of the supradiaphragmatic aortic occlusion balloon. The use of ECMO is not compatible with the acronym DCDD because circulation is restored after the determination of death. Because of these deficiencies, we concluded that other techniques are preferable, such as rapid recovery or in situ cold infusion. If ECMO is performed, it requires a specific informed consent and transparency.
Publisher Wiley
ISSN/ISBN 1601-2577 ; 1602-1363
edoc-URL http://edoc.unibas.ch/51846/
Full Text on edoc No
Digital Object Identifier DOI 10.1111/ajt.13792
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/26999771
ISI-Number WOS:000380026900010
Document type (ISI) Journal Article
 
   

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