Normothermic regional perfusion: Ethical issues in thoracic organ donation

Research output: Contribution to journalEditorial

11 Scopus citations
Original languageEnglish
Pages (from-to)147-154
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Issue number1
StatePublished - Jul 2022

Bibliographical note

Funding Information:
TA-NRP protocols require prevention of cerebral circulation to ensure permanent absence of brain function. Although it is relatively easy to prevent major vessel perfusion of the brain using ligation or balloon occlusion, collateral sources of blood flow might provide some degree of brain perfusion. Several methods have been advocated to ensure complete loss of brain circulation during TA-NRP procedures, including free drainage of aortic arch vessels to atmospheric or negative pressure, thus allowing collateral vessels, such as vertebral or spinal arteries, to drain to atmospheric pressure.13 Total absence of brain perfusion has not yet been proven definitively, but in the study from Manara and colleagues13 of 3 patients, persisting drainage of blood from the open ends of the arch vessels provides support for the presumption that ischemia is complete. Several possible means to substantiate absence of brain perfusion exist, but have not yet been systematically investigated in TA-NRP.28 For that reason, TA-NRP in the United States should be done under research protocols that include verification that perfusion of the brain stem is absent.


  • donation after circulatory-determined death
  • ethics
  • heart transplantation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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