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White paper analyzes ethical issues in normothermic regional perfusion

Published on: Friday, March 8, 2024

The OPTN Board of Directors recently approved publication of a white paper developed by the OPTN Ethics Committee analyzing the ethical implications of normothermic regional perfusion (NRP). While white papers are not OPTN policy, they inform discussions and decision making on issues related to organ donation and transplant.

NRP is a procedure used to recover organs from certain donors who have been declared dead by circulatory criteria. It involves using a machine to pass blood through organs in a person’s body after the heart has stopped beating and a waiting period has been observed. Vessels are clamped during this procedure to prevent blood flow to the brain.

The use of NRP allows more organs to be used without negatively impacting patient outcomes. However, the fact that it involves recirculation after declaration of death by circulatory criteria has raised concerns about adherence to foundational principles of medical ethics. To uphold the ethical principle of respect for persons, the Ethics Committee recommends that consistent and transparent protocols be used for the procedure, including adequate informed consent procedures for potential donors and donor families.