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Organ Donation after Circulatory Determination of Death - Consensus Statement

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Název: Organ Donation after Circulatory Determination of Death - Consensus Statement
Autoři: Avnish Kumar Seth, Ravi Mohanka, Raj Kumar Mani, Sonal Asthana, Sandeep Attawar, Kumud K. Dhital, Deepak Gupta, Roop Gursahani, Milind Hote, Anil Kumar, Krishan Kumar, Vivek B. Kute, Surendra Kumar Mathur, Dhvani Mehta, Darius F. Mirza, Pranjal Modi, Rahul Anil Pandit, Ashish Sharma, Sunil Shroff
Zdroj: Indian Journal of Transplantation, Vol 18, Iss 3, Pp 247-256 (2024)
Informace o vydavateli: Medknow, 2024.
Rok vydání: 2024
Témata: withdrawal of care, determining futility of care, RD1-811, controlled determination of death by circulatory criteria, machine perfusion, ex vivo machine perfusion, uncontrolled determination of death by circulatory criteria, circulatory determination of death, donation after circulatory death, normothermic perfusion, surrogate decision maker, do-not attempt resuscitation, retrieval in controlled determination of death by circulatory criteria, withdrawal of life-sustaining treatment, supreme court judgement, advance medical directives, delinking organ donation, maastricht classification, Surgery, no-touch period, organ preservation, life-sustaining treatments, end-of-life care
Popis: Organ donation after circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries, most commonly being category III-controlled donations. This document, prepared by a multidisciplinary group of experts, describes the feasibility of category III DCDD in India, in view of the January 2023 Supreme Court (SC) judgment simplifying the process of withdrawal of life-sustaining treatment (WLST). The paper discusses the concept and types of futility of care, how to elicit patients values and wishes, outlines its determination in several clinical situations and the process of WLST in such cases, in accordance with the SC judgement. The judgement mandates evaluation for futility of care by the primary and secondary medical boards before intimation to the judicial magistrate and WLST. The paper also discusses the use of new and upcoming organ preservation techniques and technologies in various organ transplants and outcomes of such transplants. We have also reviewed international best practices in cDCDD, discuss the ethical, medical, legal, economic, procedural, and logistic challenges in India and outline a path for DCDD in India. The manuscript discusses and compares the timing and location of WLST, consent for antemortem measures, no-touch period, and the possibility of stand-down and return to the intensive care unit (ICU) without donation. Further clarifications of aspects such as ante-mortem measures and do-not attempt resuscitation (DNAR) may be required during implementation of the judgement in some situations.
Druh dokumentu: Article
Jazyk: English
ISSN: 2212-0025
2212-0017
DOI: 10.4103/ijot.ijot_37_24
Přístupová URL adresa: https://doaj.org/article/ab8484ad735a43e39ed2aa0adb9e1ab7
Přístupové číslo: edsair.doi.dedup.....81a6147a4c004cb31fe1cd8c0575cd11
Databáze: OpenAIRE
Popis
Abstrakt:Organ donation after circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries, most commonly being category III-controlled donations. This document, prepared by a multidisciplinary group of experts, describes the feasibility of category III DCDD in India, in view of the January 2023 Supreme Court (SC) judgment simplifying the process of withdrawal of life-sustaining treatment (WLST). The paper discusses the concept and types of futility of care, how to elicit patients values and wishes, outlines its determination in several clinical situations and the process of WLST in such cases, in accordance with the SC judgement. The judgement mandates evaluation for futility of care by the primary and secondary medical boards before intimation to the judicial magistrate and WLST. The paper also discusses the use of new and upcoming organ preservation techniques and technologies in various organ transplants and outcomes of such transplants. We have also reviewed international best practices in cDCDD, discuss the ethical, medical, legal, economic, procedural, and logistic challenges in India and outline a path for DCDD in India. The manuscript discusses and compares the timing and location of WLST, consent for antemortem measures, no-touch period, and the possibility of stand-down and return to the intensive care unit (ICU) without donation. Further clarifications of aspects such as ante-mortem measures and do-not attempt resuscitation (DNAR) may be required during implementation of the judgement in some situations.
ISSN:22120025
22120017
DOI:10.4103/ijot.ijot_37_24