Practice and challenges for organ donation after medical assistance in dying: A scoping review including the results of the first international roundtable in 2021

Organ Donation After Euthanasia in Patients Suffering From Psychiatric Disorders: 10-Years of Preliminary Experiences in the Netherlands

“…The 24 cases lead to 107 (mean 4.5, range 1–7) organ transplantations. The transplanted organs were kidneys (46), lungs (35), liver ( 16 ), pancreas ( 5 ) and heart ( 2 ).…”

“…Physician assisted dying makes it possible for a patient to die a self-chosen, peaceful death. Euthanasia, where a physician administers a lethal drug intravenously to a patient, is currently legally permitted in Belgium, the Netherlands, Luxemburg, Colombia, Canada and parts of Australia ( 1 , 2 ). Recently, euthanasia was allowed in Spain since June 2021 and in New Zealand since November 2021.…”

Missed opportunities: saving lives through organ donation following voluntary assisted dying

“…Organ donation following various ‘euthanasia’ or ‘assisted dying’ protocols is currently practised in the Netherlands, Belgium, Canada and Spain 4,5 . More than 200 people have donated organs after euthanasia worldwide since 2005 4 .…”

“…However, a recent review of protocols in other countries highlights how variations in the clinical practice of assisted dying and of organ donation following circulatory determination of death may facilitate or hinder opportunities for dVAD 5 . Reliance on self‐administration of barbiturates in some Australian states in an out‐of‐hospital setting as the mode of death in VAD is likely to limit opportunities for dVAD, 12 as higher rates of donation are observed in settings where pre‐mortem clinical interventions may be used to facilitate physiological support for organs throughout the dying process as well as timely organ recovery and transplantation 5 . Efforts to enable dVAD in all Australian jurisdictions will thus require careful consideration of current VAD protocols and of DCDD protocols.…”

Medical Assistance in Dying and Organ Donation, the Ultimate Gift

“…The authors do not describe the consent process for the administration of heparin or if there is an option for administration after the provision of coma-inducing drugs, or before the administration of paralytics and cardioplegia. The average time from MAiD induction to circulatory arrest is 7 minutes when cardioplegia is administered so there should be time for circulation of heparin if given after coma induction 3. If heparin is administered after coma induction, this ensures that the patient has provided their final consent for the MAiD process, and it is guaranteed to proceed, which may not be assured if heparin is given earlier, and the patient still could stop the induction of MAiD.…”