• Christopher James Doig and Graeme Rocker.
• Department of Critical Care Medicine and The Office of Medical Bioethics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. cdoig@ucalgary.ca
• Can J Anaesth. 2003 Dec 1;50(10):1069-76.

PurposeThe increasing gap between numbers of individuals awaiting organ replacement surgery and the supply of organs available for transplant underpins attempts to increase the number of organs available. One practice, used in other countries, is the recovery of organs from non-heart-beating organ donors (NHBD). The purpose of this review is to discuss ethical issues surrounding the use of organs from these donors.SourceNarrative review from selected Medline references, and other published reports.Principal FindingsNHBD protocols have been established in many countries including the United States. Despite numerous publications, and extensive debate in the literature, significant ethical issues remain unresolved in the retrieval of organs from donors that have died from cessation of cardiac activity. The ethical concerns primarily arise in the determination of death, the tension between the time constraints on recovering organs viable for transplantation, and procedures to enhance organ viability. Despite a concerted effort in the United States, less than half of the organ procurement organizations have NHBD protocols.ConclusionCanadian centres can learn from the difficulties encountered in other centres that have developed NHBD protocols. A moratorium on Canadian NHBD protocols should be considered until a National consensus reflecting Canadian values has been undertaken.

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