American Society of Transplant Surgeons Normothermic Regional Perfusion Standards: Ethical, Legal, and Operational Conformance

Anji E Wall; Shaheed Merani; Jason Batten; Bonnie Lonze; Kristin Mekeel; Michael Nurok; Jennifer Prinz; John Gil; Elizabeth A Pomfret; James V Guarrera

doi:10.1097/TP.0000000000005115

American Society of Transplant Surgeons Normothermic Regional Perfusion Standards: Ethical, Legal, and Operational Conformance

Transplantation. 2024 Aug 1;108(8):1655-1659. doi: 10.1097/TP.0000000000005115. Epub 2024 Jul 17.

Authors

Anji E Wall¹, Shaheed Merani², Jason Batten³, Bonnie Lonze⁴, Kristin Mekeel⁵, Michael Nurok⁶, Jennifer Prinz⁷, John Gil⁸, Elizabeth A Pomfret⁹, James V Guarrera¹⁰

Affiliations

¹ Division of Abdominal Transplantation, Baylor University Medical Center, Dallas, TX.
² Division of Abdominal Transplantation, University of Nebraska, Omaha, NE.
³ Division of Critical Care Medicine, University of California Los Angeles, Los Angeles, CA.
⁴ Transplant Institute, New York University, New York, NY.
⁵ Division of Abdominal Transplantation, University of California San Diego, San Diego CA.
⁶ Departments of Anesthesiology, Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
⁷ Donor Alliance, Denver, CO.
⁸ Division of Nephrology, University of British Columbia, Vancouver, BC, Canada.
⁹ Department of Surgery, Division of Transplant Surgery, University of Colorado Anschutz Medical Campus, Denver, CO.
¹⁰ Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.

PMID: 39012935
DOI: 10.1097/TP.0000000000005115

Abstract

Background: The American Society of Transplant Surgeons convened a multidisciplinary working group to address operational, ethical, and legal considerations surrounding normothermic regional perfusion (NRP) procurement.

Methods: The working group, comprising members from American Society of Transplant Surgeons and AST across various disciplines including transplant surgery, hepatology, critical care, and bioethics, collaborated to formulate recommendations and guidance for NRP procurement.

Results: The following topics were identified by the group as essential standards that need to be addressed for ethical, legal, and operational conformance: terminology; conceptualization of death in the context of NRP; and communication, logistics, and training and competency.

Conclusions: Fourteen recommendations that support the ethical and legal acceptability of NRP in the United States and set expectations for the conduct of NRP procedures are provided.

Publication types

Practice Guideline

MeSH terms

Humans
Organ Preservation* / ethics
Organ Preservation* / methods
Organ Preservation* / standards
Organ Transplantation* / ethics
Organ Transplantation* / legislation & jurisprudence
Organ Transplantation* / standards
Perfusion*
Societies, Medical / standards
Terminology as Topic
Tissue and Organ Procurement / ethics
Tissue and Organ Procurement / legislation & jurisprudence
Tissue and Organ Procurement / standards
United States