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Can J Anaesth. 2020 Jan 2. doi: 10.1007/s12630-019-01560-z. [Epub ahead of print]

Acceptability of cardiac donation after circulatory determination of death: a survey of the Canadian public.

Author information

1
Department of Medicine, London Health Sciences Centre, Western University, London, ON, Canada. kimia.honarmand@medportal.ca.
2
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
3
Department of Medicine, London Health Sciences Centre, Western University, 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, 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
CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit, Traumatology-Emergency-Critical Care Medicine, Université Laval, 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:

Cardiac transplantation is a definitive therapy for end-stage heart failure, but demand exceeds supply. Cardiac donation after circulatory determination of death (cardiac DCDD) can be performed using direct procurement and perfusion (DPP), where cardiac activity is restored after heart recovery, or (NRP), where brain blood supply is surgically interrupted, circulation to the thoraco-abdominal organs is restored within the donor's body, followed by heart recovery. While cardiac DCDD would increase the number of heart donors, uptake of programs has been slowed in part because of ethical concerns within the medical community. These debates have been largely devoid of discussion regarding public perceptions. We conducted a national survey of public perceptions regarding cardiac DCDD.

METHODS:

We surveyed 1,001 Canadians about their attitudes towards cardiac DCDD using a rigorously designed and pre-tested survey.

RESULTS:

We found that 843 of 1,001 respondents (84.2%; 95% confidence interval [CI], 81.8 to 86.3) accepted the DPP approach, 642 (64.1%; 95% CI, 61.1 to 67.0) would agree to donate their heart using DPP, and 696 (69.5%; 95% CI, 66.6 to 72.3) would consent to the same for a family member. We found that 779 respondents of 1,001 respondents (77.8%; 95% CI, 75.1 to 80.3) accepted the NRP approach, 587 (58.6%; 95% CI, 55.5 to 61.6) would agree to donate their heart using NRP, and 636 (63.5%; 95% CI, 60.5 to 66.4) would consent to the same for a family member. Most respondents supported the implementation of DPP (738 respondents or 73.7%; 95% CI, 70.9 to 76.3) and NRP (655 respondents or 65.4%; 95% CI, 62.4 to 68.3) in Canada.

CONCLUSION:

The results of this national survey of public attitudes towards cardiac DCDD will inform the implementation of cardiac DCDD programs in a manner that is consistent with public values.

PMID:
31898773
DOI:
10.1007/s12630-019-01560-z

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