Ethics Grand Rounds | Normothermic Regional Perfusion: Ethical Challenges in the Transition from Life to Organ Donation

On October 15, 2024, Dr. Kenneth Prager, MD spoke on the ethical challenges of Normothermic Regional Perfusion (NRP), in conversation with Division of Ethics Chief Sandra Soo-Jin Lee, PhD, as part of the Ethics Grand Rounds Series. NRP, a method used in organ transplantation that re-establishes blood flow to organs after circulatory death, has been the subject of intense ethical debate due to questions about the criteria for determining death.

Speakers:

• Kenneth Prager, MD, Professor of Medicine, Co-Director of Clinical Ethics, Co-Chair of the Medical Ethics Committee, Columbia University Medical Center
• Sandra Soo-Jin Lee, PhD, Chief of the Division of Ethics, Professor of Medical Humanities and Ethics, Columbia University Medical Center

Resource List 

Peer Reviewed Articles 

• Applying the ethical framework for donation after circulatory death to thoracic normothermic regional perfusion procedures(link is external and opens in a new window)

• Early US experience with cardiac donation after circulatory death (DCD) using normothermic regional perfusion(link is external and opens in a new window)

• Ethical and logistical concerns for establishing NRP-cDCD heart transplantation in the United States(link is external and opens in a new window)

• Normothermic regional perfusion and US legal standards for determining death are not aligned(link is external and opens in a new window)

• Neither Ethical nor Prudent Why Not to Choose Normothermic Regional Perfusion(link is external and opens in a new window)

• Response to American College of Physician’s statement on the ethics of transplant after normothermic regional perfusion(link is external and opens in a new window)

Policy Statements 

• Ethical Analysis of Normothermic Regional Perfusion(link is external and opens in a new window)

• Ethics, Determination of Death, and Organ Transplantation in Normothermic Regional Perfusion (NRP) with Controlled Donation after Circulatory Determination of Death (cDCD): American College of Physicians Statement of Concern(link is external and opens in a new window)

• AOPO Statement on Normothermic Regional Perfusion(link is external and opens in a new window)

• Uniform Determination of Death Act(link is external and opens in a new window)

News Articles 

• When Does Life Stop? A New Way of Harvesting Organs Divides Doctors.(link is external and opens in a new window)