Titre
The ethics of extracorporeal membrane oxygenation in brain-dead potential organ donors.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Dalle Ave, A.L.
Auteure/Auteur
Gardiner, D.
Auteure/Auteur
Shaw, D.M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1432-2277
Statut éditorial
Publié
Date de publication
2016
Volume
29
Numéro
5
Première page
612
Dernière page/numéro d’article
618
Peer-reviewed
Oui
Langue
anglais
Résumé
Organ-preserving extracorporeal membrane oxygenation (OP-ECMO) is defined as the use of extracorporeal support for the primary purpose of preserving organs for transplantation, rather than to save the patient's life. This paper discusses the ethics of using OP-ECMO in donation after brain determination of death (DBDD) to avoid the loss of organs for transplantation. We review case reports in the literature and analyze the ethical issues raised. We conclude that there is little additional ethical concern in continuing OP-ECMO in patients already on ECMO if they become brain dead. The implementation of OP-ECMO in hemodynamically unstable brain-dead patients is ethically permissible in certain clinical situations but requires specific consent from relatives if the patient's wish to donate is not clear. If no evidence of a patient's wish to donate is available, OP-ECMO is not recommended. In countries with presumed consent legislation, failure to opt out should be considered as a positive wish to donate. If a patient is not-yet brain-dead or is undergoing testing for brain death, OP-ECMO is not recommended. Further research on OP-ECMO is needed to better understand the attitudes of professionals, families, and lay people to ensure agreement on key ethical issues.
PID Serval
serval:BIB_3545303F9F6C
PMID
Open Access
Oui
Date de création
2016-02-16T16:50:05.072Z
Date de création dans IRIS
2025-05-20T20:16:15Z