Organ Donation after Circulatory Determination of Death in India: A Joint Position Paper.
Circulatory death
Donation
Organ donation
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
2022
2022
Historique:
entrez:
3
6
2022
pubmed:
4
6
2022
medline:
4
6
2022
Statut:
ppublish
Résumé
Organ donation following circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries. In India, majority of deceased donations happen following brain death (BD). While existing legislation allows for DCDD, there have been only few reports of kidney transplantation following DCDD from India. This document, prepared by a multidisciplinary group of experts, reviews international best practices in DCDD and outlines the path for DCDD in India. Ethical, medical, legal, economic, procedural, and logistic challenges unique to India have been addressed. The practice of withdrawal of life-sustaining treatment (WLST) in India, laid down by the Supreme Court of India, is time-consuming, possible only in patients in a permanent vegetative state, and too cumbersome for day-to-day practice. In patients where continued medical care is futile, the procedure for WLST is described. In controlled DCDD (category-III), decision for WLST is independent of and delinked from the subsequent possibility of organ donation. Families that are inclined toward organ donation are explained the procedure including 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. In donation following neurologic determination of death (DNDD), if cardiac arrest occurs during the process of BD declaration, the protocol for DCDD category-IV has been described in detail. In DCDD category-V, organ donation may be possible following unsuccessful cardiopulmonary resuscitation of cardiac arrest in the ICU. An outline of organ-specific requisites for kidney, liver, heart, and lung transplantation following DCDD and techniques, such as normothermic regional perfusion (nRP) and Seth AK, Mohanka R, Navin S, Gokhale AGK, Sharma A, Kumar A,
Identifiants
pubmed: 35656056
doi: 10.5005/jp-journals-10071-24198
pmc: PMC9067489
doi:
Types de publication
Journal Article
Langues
eng
Pagination
421-438Informations de copyright
Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.
Déclaration de conflit d'intérêts
Source of support: Nil Conflict of interest: None
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