Abstract:To increase the number of organ donors in England, the government will implement Max and Keira's Law: all adults over the age of 18 living in the United Kingdom become potential organ donors a er their death, unless they choose to opt out. The law will be employed by spring 2020. Despite there being presumed consent for the retrieval of organs, families of the deceased will still be contacted to recheck consent, and ensure that family wishes are upheld.
“…In an effort to improve organ availability, legislators from several countries have implemented laws that aim to increase the amount of organ donations and improve the selection criteria for transplant allocation. This includes the introduction of opt-out laws, such as the Max and Keira's law [3] in the UK, where, adults are considered to have given consent for their organs to be donated unless documented otherwise [4]. Another such law introduced in the US aims to revise how organ allocation works, moving away from a region-based approach to a priority-system based on donor-organ range to transplant centres dictated by the organs' preservation time.…”
With the ever-increasing disparity between the number of patients waiting for organ transplants and the number organs available, some patients are unable to receive life-saving transplantation in time. The present, widely-used form of preservation is proving to be incapable of maintaining organ quality during long periods of preservation and meeting the needs of an ever-changing legislative and transplantation landscape. This has led to the need for improved preservation techniques. One such technique that has been extensively researched is gaseous oxygen perfusion or Persufflation (PSF). This method discovered in the early 20th century has shown promise in providing both longer term preservation and organ reconditioning capabilities for multiple organs including the liver, kidneys, and pancreas. PSF utilises the organs own vascular network to provide oxygen to the organ tissue and maintain metabolism during preservation to avoid hypoxic damage. This review delves into the history of this technique, its multiple different approaches and uses, as well as in-depth discussion of work published in the past 15 years. Finally, we discuss exciting commercial developments which may help unlock the potential for this technique to be applied at scale.
“…In an effort to improve organ availability, legislators from several countries have implemented laws that aim to increase the amount of organ donations and improve the selection criteria for transplant allocation. This includes the introduction of opt-out laws, such as the Max and Keira's law [3] in the UK, where, adults are considered to have given consent for their organs to be donated unless documented otherwise [4]. Another such law introduced in the US aims to revise how organ allocation works, moving away from a region-based approach to a priority-system based on donor-organ range to transplant centres dictated by the organs' preservation time.…”
With the ever-increasing disparity between the number of patients waiting for organ transplants and the number organs available, some patients are unable to receive life-saving transplantation in time. The present, widely-used form of preservation is proving to be incapable of maintaining organ quality during long periods of preservation and meeting the needs of an ever-changing legislative and transplantation landscape. This has led to the need for improved preservation techniques. One such technique that has been extensively researched is gaseous oxygen perfusion or Persufflation (PSF). This method discovered in the early 20th century has shown promise in providing both longer term preservation and organ reconditioning capabilities for multiple organs including the liver, kidneys, and pancreas. PSF utilises the organs own vascular network to provide oxygen to the organ tissue and maintain metabolism during preservation to avoid hypoxic damage. This review delves into the history of this technique, its multiple different approaches and uses, as well as in-depth discussion of work published in the past 15 years. Finally, we discuss exciting commercial developments which may help unlock the potential for this technique to be applied at scale.
Purpose of review
The purpose of this review is to present and analyse recent literature on the patterns, trends, and developments of ethical considerations concerning xenotransplantation by appraising normative aspects within a coherent framework.
Recent findings
Developments within xenotransplantation may soon allow for pig-to-human xenotransplantation to take place. Ethical analysis of xenotransplantation commonly follows an anthropocentric cost–benefit analysis, which may imprecisely measure costs. Xenotransplantation should not merely be approached from an anthropocentric perspective. Rather, the potential risks presented to human and nonhuman donors, recipients, and third parties should all be thoroughly considered.
Summary
The range of feasible alternatives to xenotransplantation to increase organ supply should be examined before resorting to xenotransplantation because of the moral distinction between imposing certain risks on others before, or after, alternative solutions have been exhausted.
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