Ethical and legal issues in non-heart-beating organ donation.

摘要: Procurement of kidneys and livers from non-heart-beating donors (NHBDs) raises ethical legal issues that need to be considered carefully before wider use these donors. Although NHBDs were used in kidney transplantation as early the 1960s, retrieval organs is by no means universally accepted today. From a medical point view, have long been "marginal" because majority show delayed or impaired graft function. Legal problems include determination death cardiopulmonary criteria, issue proper consent, organ preservation measures. Among raised are observance Dead-donor Rule, decision-making surrounding resuscitation, withdrawal life-support, respect for dying patient dead body, well information guidance family. In Netherlands NHB donation was pioneered Maastricht Medical Center 1980s. Today, all seven transplant centers retrieve donors, become an important source transplantable livers. Recent legislation also supports making possible measures after circulatory arrest, even absence family consent. As result, one every three transplanted 2004 obtained NHBD. this study, Dutch NHBD protocols, practice, results analyzed compared with international practices.