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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2016 March;82(3):359-68


“Why can’t I give you my organs after my heart has stopped beating?” An overview of the main clinical, organisational, ethical and legal issues concerning organ donation after circulatory death in Italy

Alberto GIANNINI 1, Massimo ABELLI 2, Giampaolo AZZONI 3, Gianni BIANCOFIORE 4, Franco CITTERIO 5, Paolo GERACI 6, Nicola LATRONICO 7, 8, Mario PICOZZI 9, Francesco PROCACCIO 10, Luigi RICCIONI 11, Paolo RIGOTTI 12, Franco VALENZA 13, Sergio VESCONI 14, Nereo ZAMPERETTI 15, on behalf of The Working Group on DCD of the Italian Society of Anesthesiology, Analgesia and Intensive Care (SIAARTI), and the Italian Society for Organ Transplantation

1 Terapia Intensiva Pediatrica, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 2 Unità Trapianto di Rene, Dipartimento di Chirurgia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 3 Dipartimento di Giurisprudenza, Università di Pavia, Pavia, Italy; 4 S. D. Anestesia e Rianimazione Trapianto Fegato, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy; 5 Trapiantologia Renale, Dipartimento di Scienze Chirurgiche, Policlinico “A. Gemelli” Università Cattolica del Sacro Cuore, Rome, Italy; 6 Centro Coordinamento Donazioni e Trapianti, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 7 Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italy; 8 Dipartimento di Anestesia e Rianimazione Emergenza Urgenza, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy; 9 Dipartimento di Biotecnologie e Scienze della Vita, Sezione di Medicina Legale Università degli Studi dell’Insubria, Varese, Italy; 10 Centro Nazionale Trapianti, Istituto Superiore di Sanità, Rome, Italy; 11 Centro per Shock e Trauma, Ospedale San Camillo-Forlanini, Rome, Italy; 12 Unità Trapianti di Rene e Pancreas, Azienda Ospedaliera di Padova, Università di Padova, Padua, Italy; 13 Dipartimento di Fisiopatologia e dei Trapianti, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 14 Coordinamento Prelievo Organi e Tessuti, Regione Lombardia, Direzione Generale Salute, Milan, Italy; 15 Servizio Qualità, Sicurezza ed Accreditamento, Azienda ULSS n. 6 Vicenza, Vicenza, Italy

Donation after circulatory death (DCD) is a valuable option for the procurement of functioning organs for transplantation. Clinical results are promising and public acceptance is quite good in most western countries. Yet, although DCD is widespread in Europe, several problems still persist in Italy as well as in some other countries. This paper aims to describe the main clinical, organisational, ethical and legal issues at stake, bearing in mind the particular situation created by Italian legislation. Currently, as regards DCD, Italy is somewhat different from other countries. Therefore, every effort should be made for the safe and effective implementation of DCD programs: uncontrolled DCD programs should be promoted and encouraged, within the framework of shared and authoritative rules. At the same time, we need to tackle the question of controlled DCD, promoting debate among all involved subjects regarding the fundamental issues of end-of-life care within protocols that best integrate the highest standard of care for the dying and the legitimate interests of those awaiting a life-saving organ.

language: English


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