NRP (Normothermic Regional Perfusion) is a new technique used by some transplant centers to improve the quality of organs obtained during donations acquired after death by cardiac criteria (DCD). As of the date of this talk, NRP has not yet been used at CHOP. Traditionally in DCD, life sustaining technology is removed, the heart stops beating, and a 5-minute waiting time is observed to ensure that the heart does not start beating again; after this, the organs are removed by the transplant team. One drawback of traditional DCD is that the organs are damaged during the 5-minute waiting time due to the absence of blood circulation. NRP uses ECMO to restore blood flow to the thoracic organs after a patient has been pronounced dead, often resulting in the heart restarting with the goal of improved organ quality. While the thoracic organs receive important blood flow, the major arteries to the brain are tied off to avoid blood being provided to the brain. NRP raises many ethical questions which will be discussed during this Ethics Grand Rounds.
Learning Objectives:
- Introduce key ethical challenges that arise during normothermic regional perfusion
- Explain legal frameworks that are relevant to implementation of normothermic regional perfusion
- Discuss areas of consensus and divergence that will influence whether and how normothermic regional perfusion can advance, with particular attention to the pediatric context
Speaker:
- Brendan Parent, JD
This seminar was delivered as an Ethics Grand Rounds Lecture at Children’s Hospital of Philadelphia, on September 4, 2024.
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Course Includes
- 1 Lesson
- Course Certificate