Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2013, Issue S2


Plata MJJ
Ethical arguments supporting donation after cardiac arrest
Cir Gen 2013; 35 (S2)

Language: Español
References: 43
Page: 143-154
PDF: 4. Kb.


Full text




ABSTRACT

When clinical transplantation became a reality during the first part of last century, all organs were retrieved from patients declared “clinically death”. In those cases donors were taken to the operating room after cardiorespiratory arrest and their organs were surgically obtained immediately after a “certified doctor” had declared the patient’s death. After the ad hoc committee resolution endorsed the concept that irreversible damage to the brainstem represents the death of the person as a unit not the occurrence of cardiac arrest, organ retrieval rapidly switched from patents “clinically death” in whom their hearts had stopped beating to patients certified dead after brainstem permanent dysfunction in whom their hearts are still beating during organ retrieval. These heart-beating-donors have become the principal source of organs for transplantation for the last 40 years. However, the number of heart-beating-donors is not increasing at the same rate of the need for organs for transplantation, therefore reintroduction of organ retrieval from patients with irreversible brain damage that not fulfill the brain death criteria, patients with massive irreversible cardiac injury, end-stage pulmonary or muscular disease, whom voluntarily decided by themselves or their surrogate decision maker´s to withdrawal life sustaining treatment offers a possibility of a new pool of organs for transplantation. The transplant community agrees that the use of organs from these donors is an effective strategy to increase the number of organs available for transplantation and reduce the number of patients dying on the waiting list but had stressed the need to consolidate this practice through an strict observance of the ethical implication and lawfulness of clinical interventions that characterize organ donation after cardiorespiratory arrest. This article highlights the ethical challenges associated with these particular model of organ donation and suggests strategies to resolve satisfactorily this ethical dilemmas.


Key words: Ethics, organ, cardiac arrest.


REFERENCIAS

  1. Haller M, Gutjahr G, Kramar R, Harnoncourt F, Oberbauer R. Cost-effectiveness analysis of renal replacement therapy in Austria. Nephrol Dial Transplant. 2011; 26: 2988-95.

  2. Bradley JA, Hardy M, Neuberger J, Sachs D, Suthanthiran M, Wood K, Monaco AP, Morris PJ. Transplantation: a report of progress. Transplantation. 2010; 90: 1245.

  3. Callaghan CJ, Bradley JA. Current status of renal transplantation. Methods Mol Biol. 2006; 333: 1-28.

  4. Knoll G. Trends in kidney transplantation over the past decade. Drugs. 2008; 68: 3-10.

  5. Veroux M, Corona D, Veroux P. Kidney transplantation: future challenges. Minerva Chir. 2009; 64: 75-100.

  6. De Lima JJ, Gowdak LH, de Paula FJ, Arantes RL, César LA, Ramires JA, Krieger EM. Unexplained sudden death in patients on the waiting list for renal transplantation. Nephrol Dial Transplant. 2011; 26: 1392-6.

  7. Montgomery RA. Living donor exchange programs: theory and practice. Br Med Bull. 2011; 98: 21-30.

  8. Montgomery RA, Lonze BE, King KE, Kraus ES, Kucirka LM, Locke JE, Warren DS, et al. Desensitization in HLA-incompatible kidney recipients and survival. N Engl J Med. 2011; 365: 318-26.

  9. Süsal C, Morath C. Current approaches to the management of highly sensitized kidney transplant patients. Tissue Antigens. 2011; 77: 177-86.

  10. Melancon JK, Cummings LS, Graham J, Rosen-Bronson S, Light J, Desai CS, Girlanda R, et al. Paired kidney donor exchanges and antibody reduction therapy: novel methods to ameliorate disparate access to living donor kidney transplantation in ethnic minorities. J Am Coll Surg. 2011; 212: 740-5.

  11. Tuppin P, Hiesse C, Caillé Y, Kessler M. Living-donor kidney transplantation: Activities in the European countries and of the North America (2001-2009). Nephrol Ther. 2011; 7: 526-30.

  12. Egawa H. Transplantation: Minimizing the risks for living donors of right lobe liver grafts. Nat Rev Gastroenterol Hepatol. 2011; 8: 251-2.

  13. Feng XN, Ding CF, Xing MY, Cai MX, Zheng SS. Technical aspects of biliary reconstruction in adult living donor liver transplantation. Hepatobiliary Pancreat Dis Int. 2011; 10: 136-42.

  14. Kootstra G, Daemen JH, Oomen AP. Categories of non-heart-beating donors. Transplant Proc. 1995: 27: 2893-4

  15. Daemen JHC, de Wit RJ, Bronkhorst MWGA, et al. Non-heart-beating donor program contributes 40% of kidneys for transplantation. Transplant Procc. 1996; 28: 105-6.

  16. Daemen JHC, Oomen APA, Kelders WPA, et al. The potential pool of non-heart-beating kidney donors. Clin Transplant. 1997; 11: 149.

  17. Watson CJ, Dark JH. Organ transplantation: historical perspective and current practice. Br J Anaesth. 2012; 108(S1): i29-i42.

  18. Starzl TE, Marchioro TL, Huntley RT, et al. Experimental and clinical homotransplantation of the liver. Ann N Y Acad Sci. 1964; 120: 739-65.

  19. Calne RY, Williams R, Dawson JL, et al. Liver transplantation in man. II. A report of two orthotopic liver transplants in adult recipients. Br Med J. 1968; 4: 541-6.

  20. Dong E Jr, Lower RR, Hurley EJ, Shumway NE. Transplantation of the heart. Dis Chest. 1965; 48: 455-7

  21. Barnard CN. Human cardiac transplantation. An evaluation of the first two operations performed at the Groote Schuur Hospital, Cape Town. Am J Cardiol. 1968; 22: 584-96.

  22. Ross D. Report of a heart transplant operation. Am J Cardiol. 1968; 22: 838-9.

  23. Conference of the Medical Royal College and their faculties in the United Kingdom. Diagnosis of brain death. Br Med J. 1976: 2: 1187-8.

  24. Conference of the Medical Royal College and their faculties in the United Kingdom. Diagnosis of brain death. Lancet. 1976: 1069-70.

  25. Report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. A definition of irreversible coma. J Am Med Assoc. 1968; 205: 337-40.

  26. Machado C. The first Organ Transplant from a Brain-dead donor. Neurology. 2005; 66: 460-461.

  27. Manara AR. Murphy PG, O’Callaghan G. Donation after circulatory death. Br J Anesthesia. 2012; 108(S1): 1108-1121.

  28. Toossi S, Lomen-Hoerth C, Josephson SA, et al. Organ donation after cardiac death in amyotrophic lateral sclerosis. Ann Neurol. 2012; 71: 154-6.

  29. Smith TJ, Vota S, Patel S, et al. Organ donation after cardiac death from withdrawal of life support in patients with amyotrophic lateral sclerosis. J Palliat Med. 2012; 15: 16-19.

  30. Institute of Medicine. Non-heart beating organ Transplantation: Practice and Protocols. Washington DC, national Academy of Press, 2000. Disponible en: http: //www.nap.edu/openbook.php/record_id=9700&pageR1

  31. Department of Health. Recommendations of the quinquennial review of the UKTSSA, UK. The Review of The United Kingdom Transplant Service Authority; 1999.

  32. Steinbrook R. Organ donation after cardiac death. NEJM. 2007; 357: 209-2013.

  33. Rady M Verheijde G, McGregor K, et al. Organ procurement after cardiocirculatory death: a critical analysis. J Intensive Care Med. 2008; 23: 303-312.

  34. Vincent JL, Abraham E, Moore FA, et al. Organ Donation after cardiac death. In: Text book of critical care, Philadelphia Saunders; 2011.

  35. Estadísticas del Centro Nacional de Trasplantes de México [consultado el 30 de abril de 2013]. Disponible en: http: //www.cenatra.salud.gob.mx/interior/trasplante_estadisticas.html

  36. Poder Legislativo. Constitución Política de los Estados Unidos Mexicanos. Disponible en: http: //www.diputados.gob.mx/LeyesBiblio/pdf/1.pdf

  37. Secretaría de Salud. Ley General de Salud de México. Disponible en: http: //www.salud.gob.mx/unidades/cdi/legis/lgs/index-indice.htm

  38. Blackstock M, McKeown Ray DC. Controlled organ donation after cardiac death: potential donors in the emergency department. Transplantation. 2010; 89: 1149-53.

  39. Plata-Muñoz JJ, Vazquez-Montes M, Friend PJ, Fuggle SV. The deceased donor score system in kidney transplants from deceased donors after cardiac death. Transpl Int. 2010; 23: 131-9.

  40. Kumar R, Shekar, Widdicombe N, et al. Donation after cardiac death in Queensland: review of the pilot project. Anaesth Intensive Care. 2012; 40: 517-522.

  41. Huddle TS, Schwartz MA, Bailey FA, Bos MA. Organ transplantation and medical practice. Philos Ethics Humanit Med. 2008; 4: 5.

  42. Rodríguez-Arias D, Smith MJ, Lazar NM. Donation after circulatory death: burying the dead donor rule. Am J Bioeth. 2011; 11: 36-43.

  43. Miller FG, Truog RD, Brock DW. The dead donor rule: can it with stand critical scrutiny? J Med Philos. 2010; 35: 299-312.






>Journals >Cirujano General >Year 2013, Issue S2
 

· Journal Index 
· Links 






       
Copyright 2019