Beyond the Final Heartbeat: Neurological Perspectives on Normothermic Regional Perfusion for Organ Donation after Circulatory Death

Matthew P. Kirschen, Ariane Lewis, Michael A. Rubin, Panayiotis N. Varelas, David M. Greer

Research output: Contribution to journalReview articlepeer-review

Abstract

Normothermic regional perfusion (NRP) has recently been used to augment organ donation after circulatory death (DCD) to improve the quantity and quality of transplantable organs. In DCD-NRP, after withdrawal of life-sustaining therapies and cardiopulmonary arrest, patients are cannulated onto extracorporeal membrane oxygenation to reestablish blood flow to targeted organs including the heart. During this process, aortic arch vessels are ligated to restrict cerebral blood flow. We review ethical challenges including whether the brain is sufficiently reperfused through collateral circulation to allow reemergence of consciousness or pain perception, whether resumption of cardiac activity nullifies the patient's prior death determination, and whether specific authorization for DCD-NRP is required. ANN NEUROL 2024;95:1035–1039.

Original languageEnglish (US)
Pages (from-to)1035-1039
Number of pages5
JournalAnnals of Neurology
Volume95
Issue number6
DOIs
StatePublished - Jun 2024

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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