Kimia Honarmand1, Jeanna Parsons Leigh2, John Basmaji3, Claudio M Martin3, Robert Sibbald4, Dave Nagpal3, Vince Lau3, Fran Priestap3, Sabe De5, Andrew Healey6,7, Sonny Dhanani8,9, Matthew J Weiss10,11,12, Sam Shemie13, Ian M Ball3,2. 1. Department of Medicine, Western University, London Health Sciences Centre, London, ON, Canada. kimia.honarmand@medportal.ca. 2. Department of Epidemiology and Biostatistics, Western University, London, ON, Canada. 3. Department of Medicine, Western University, London Health Sciences Centre, London, ON, Canada. 4. Department of Family Medicine, Western University, London, ON, Canada. 5. Division of Cardiology, Western University, London, ON, Canada. 6. Trillium Gift of Life Network, Toronto, ON, Canada. 7. Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada. 8. Department of Pediatrics, University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. 9. Division of Pediatric Critical Care, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. 10. Division of Pediatric Intensive Care, Centre-Mère Enfant Soleil du CHU de Québec, Québec City, QC, Canada. 11. Department of Pediatrics, Faculté de Médecine, Université Laval, Québec City, QC, Canada. 12. Population Health and Optimal Health Practices Research Unit, Traumatology-Emergency-Critical Care Medicine, Université Laval, CHU de Québec - Université Laval Research Center, Québec City, QC, Canada. 13. Deceased Organ Donation, Canadian Blood Services and Division of Critical Care Medicine, Montreal Children's Hospital and McGill University Health Centre & Research Institute, Montreal, QC, Canada.
Abstract
PURPOSE: The number of patients on cardiac transplant waitlists exceeds the number of available donor organs. Cardiac donation is currently limited to those declared dead by neurologic criteria in all but three countries. Cardiac donation after circulatory determination of death (cardiac DCDD) can be conducted using direct procurement and perfusion (DPP) or normothermic regional perfusion (NRP). Implementation of cardiac DCDD in many countries has been slowed by ethical debates within the donation and transplantation community. We conducted a national survey to determine the perceptions of healthcare providers regarding cardiac DCDD. METHODS: We conducted an electronic survey of 398 healthcare providers who are involved in the management of heart donors and/or heart transplant recipients in Canada (226 nurses, 82 critical care physicians, 31 donation specialists, and 59 transplant specialists). Our primary outcomes were their attitudes towards and concerns regarding cardiac DCDD protocols and their implementation in Canada. We distributed the survey electronically through several Canadian donation and transplantation organizations. RESULTS: We identified that 361 of 391 respondents (92.3%; 95% confidence interval [CI], 89.6 to 95.1) believed that DPP is acceptable, and 329 of 377 respondents (87.3%; 95% CI, 83.9 to 90.7) supported its implementation in Canada. We found that 301 of 384 respondents (78.4%; 95% CI, 74.2 to 82.6) believed that NRP is acceptable and 266 of 377 respondents (70.6%; 95% CI, 66.0 to 75.2) supported its implementation in Canada. CONCLUSION: This is the first survey describing the attitudes of healthcare providers towards cardiac DCDD. We identified widespread support for cardiac DCDD and its implementation in Canada among Canadian healthcare providers within the organ donation and transplantation community in Canada.
PURPOSE: The number of patients on cardiac transplant waitlists exceeds the number of available donor organs. Cardiac donation is currently limited to those declared dead by neurologic criteria in all but three countries. Cardiac donation after circulatory determination of death (cardiac DCDD) can be conducted using direct procurement and perfusion (DPP) or normothermic regional perfusion (NRP). Implementation of cardiac DCDD in many countries has been slowed by ethical debates within the donation and transplantation community. We conducted a national survey to determine the perceptions of healthcare providers regarding cardiac DCDD. METHODS: We conducted an electronic survey of 398 healthcare providers who are involved in the management of heart donors and/or heart transplant recipients in Canada (226 nurses, 82 critical care physicians, 31 donation specialists, and 59 transplant specialists). Our primary outcomes were their attitudes towards and concerns regarding cardiac DCDD protocols and their implementation in Canada. We distributed the survey electronically through several Canadian donation and transplantation organizations. RESULTS: We identified that 361 of 391 respondents (92.3%; 95% confidence interval [CI], 89.6 to 95.1) believed that DPP is acceptable, and 329 of 377 respondents (87.3%; 95% CI, 83.9 to 90.7) supported its implementation in Canada. We found that 301 of 384 respondents (78.4%; 95% CI, 74.2 to 82.6) believed that NRP is acceptable and 266 of 377 respondents (70.6%; 95% CI, 66.0 to 75.2) supported its implementation in Canada. CONCLUSION: This is the first survey describing the attitudes of healthcare providers towards cardiac DCDD. We identified widespread support for cardiac DCDD and its implementation in Canada among Canadian healthcare providers within the organ donation and transplantation community in Canada.
Authors: George Skowronski; Anil Ramnani; Dianne Walton-Sonda; Cynthia Forlini; Michael J O'Leary; Lisa O'Reilly; Linda Sheahan; Cameron Stewart; Ian Kerridge Journal: BMC Med Ethics Date: 2021-12-18 Impact factor: 2.652
Authors: Nicholas Murphy; Lorelei Lingard; Laurie Blackstock; Mary Ott; Marat Slessarev; John Basmaji; Mayur Brahmania; Andrew Healey; Sam Shemie; Anton Skaro; Lindsay Wilson; Charles Weijer Journal: BMJ Open Date: 2022-09-29 Impact factor: 3.006
Authors: Kimia Honarmand; Ian Ball; Matthew Weiss; Marat Slessarev; Robert Sibbald; Aimee Sarti; Maureen Meade; Frédérick D'Aragon; Michael Chasse; John Basmaji; Jeanna Parsons Leigh Journal: BMJ Open Date: 2020-07-20 Impact factor: 2.692