Non-heart-beating organ transplantation : medical and ethical issues in procurement / Division of Health Care Services, Institute of Medicine ; Roger Herdman, study director, and John T. Potts, principal investigator.

Format:

Book

Author/Creator:

Potts, John T., 1932-

Contributor:

Herdman, Roger.

Institute of Medicine (U.S.). Division of Health Care Services.

Language:

English

Subjects (All):

Non-heart-beating organ donation--Moral and ethical aspects.

Non-heart-beating organ donation.

Organ donors.

Physical Description:

1 online resource (x, 92 pages) : map

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1997.

Language Note:

English

Summary:

Non-heart-beating donors (individuals whose deaths are determined by cessation of heart and respiratory function rather than loss of whole brain function) could potentially be of major importance in reducing the gap between the demand for and available supply of organs for transplantation. Prompted by questions concerning the medical management of such donors--specifically, whether interventions undertaken to enhance the supply and quality of potentially transplantable organs (i.e. the use of anticoagulants and vasodilators) were in the best interests of the donor patient--the U.S. Department of Health and Human Services asked the Institute of Medicine to examine from scientific and ethical points of view "alternative medical approaches that can be used to maximize the availability of organs from a] donor in an end-of-life situation] without violating prevailing ethical norms...." This book examines transplantation supply and demand, historical and modern conceptions of non-heart-beating donors, and organ procurement organizations and transplant program policies, and contains recommendations concerning the principles and ethical issues surrounding the topic.

Contents:

Non-Heart-Beating Organ Transplantation

Copyright

Preface

ACKNOWLEDGEMENTS

Senior Special Experts

Contents

Executive Summary

1 Introduction

2 Transplantation Supply and Demand

SUPPLY

DEMAND

IMPROVING SUPPLY

3 Background

THE HISTORICAL NHBD

NEUROLOGIC CRITERIA FOR DEATH

4 The Modern Non-Heart-Beating Donor

THE CONTROLLED NHBD

THE UNCONTROLLED NHBD

CURRENT STATUS OF THE NHBD IN TRANSPLANTATION

5 Survey of Organ Procurement Organization and Transplant Program Policies

INTEREST IN OPO NHBD PROTOCOLS

PROTOCOL STATISTICS

IDENTIFICATION OF POTENTIAL DONORS

APPROACH TO FAMILY FOR CONSENT

OPO AND PROCUREMENT TEAM INTERVENTION BEFORE DEATH

MEDICATION

WITHDRAWAL OF LIFE SUPPORT AND DECLARATION OF DEATH

UNCONTROLLED NHDS

CONCLUSION

6 Analysis, Findings, and Recommendations

GENERAL PRINCIPLES

POLICIES AND OVERSIGHT

MEDICAL INTERVENTIONS AND ETHICS

CONFLICTS OF INTEREST

DETERMINATION OF DEATH

FAMILIES

References

Appendix A Letter to the Institute of Medicine from the Department of Health and Human Services

Appendix B Agenda and Summary of Workshop on Medical and Ethical Issues in Maintaining the Viability of Organs for…

AGENDA

WORKSHOP SUMMARY

Federal Government and Political Considerations

UNOS: Procurement, Allocation, and Data Collection

Organ Procurement Issues in the Context of the NHBD

Scientific Issues and Medical Perspectives

TRANSPLANT COORDINATION

NHBD Supply, Results, Projections, and Other Information

Consumer Concerns of Donors and Recipients

Scientific Issues and Surgical Perspectives

Ethical Concerns

Determination of Death

Interventions to Promote Organ Viability

Conflicts of Interest

Conclusion.

Appendix C U.S. Organ Procurement Organizations and Letter of Request for Non-Heart-Beating Donor Protocols.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references (p. 65-72).

ISBN:

9786610210237

9780309174206

0309174201

9781280210235

1280210230

9780309593106

0309593107

9780585023861

0585023867

OCLC:

923262970