The ethics of Extracorporeal Membrane Oxygenation in brain-dead potential organ donors
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 3693546
Author(s) Dalle Ave, Anne; Gardiner, Dale; Shaw, David
Author(s) at UniBasel Shaw, David
Year 2016
Title The ethics of Extracorporeal Membrane Oxygenation in brain-dead potential organ donors
Journal Transplant International
Volume 29
Number 5
Pages / Article-Number 612-618
Abstract Organ-preserving extracorporeal membrane oxygenation (OP-ECMO) is defined as the use of extracorporeal support for the primary purpose of preserving organs for transplantation, rather than to save the patient's life. This paper discusses the ethics of using OP-ECMO in donation after brain determination of death (DBDD) to avoid the loss of organs for transplantation. We review case reports in the literature and analyze the ethical issues raised. We conclude that there is little additional ethical concern in continuing OP-ECMO in patients already on ECMO if they become brain dead. The implementation of OP-ECMO in hemodynamically unstable brain-dead patients is ethically permissible in certain clinical situations but requires specific consent from relatives if the patient's wish to donate is not clear. If no evidence of a patient's wish to donate is available, OP-ECMO is not recommended. In countries with presumed consent legislation, failure to opt out should be considered as a positive wish to donate. If a patient is not-yet brain-dead or is undergoing testing for brain death, OP-ECMO is not recommended. Further research on OP-ECMO is needed to better understand the attitudes of professionals, families, and lay people to ensure agreement on key ethical issues.
Publisher Wiley
ISSN/ISBN 0934-0874 ; 1432-2277
Full Text on edoc No
Digital Object Identifier DOI 10.1111/tri.12772
ISI-Number WOS:000375064100011
Document type (ISI) Article

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