Outcomes from organ donation following medical assistance in dying: A scoping review

Vanessa Silva E Silva; Amina Silva; Andrea Rochon; Ken Lotherington; Laura Hornby; Tineke Wind; Jan Bollen; Lindsay C Wilson; Aimee J Sarti; Sonny Dhanani

doi:10.1016/j.trre.2023.100748

Outcomes from organ donation following medical assistance in dying: A scoping review

Transplant Rev (Orlando). 2023 Jan;37(1):100748. doi: 10.1016/j.trre.2023.100748. Epub 2023 Feb 6.

Authors

Affiliations

¹ School of Nursing, Brock University, St. Catharines, ON, Canada. Electronic address: [email protected].
² Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
³ School of Nursing, St. Lawrence College, Kingston, ON, Canada.
⁴ Canadian Blood Services, Ottawa, ON, Canada.
⁵ Maastricht University Medical Centre, Maastricht, Netherlands.
⁶ Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc Medical Center Nijmegen, Nijmegen, Netherlands.
⁷ Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.
⁸ Faculty of Medicine, Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.

PMID: 36774782
DOI: 10.1016/j.trre.2023.100748

Abstract

Aim: To collate and summarize the current international literature on the transplant recipient outcomes of organs from Medical Assistance in Dying (MAiD) donors, as well as the actual and potential impact of organ donation following MAiD on the donation and transplantation system.

Background: The provision of organ donation following MAiD can impact the donation and transplantation system, as well as potential recipients of organs from the MAiD donor, therefore a comprehensive understanding of the potential and actual impact of organ donation after MAiD on the donation and transplantation systems is needed.

Design: Scoping review using the JBI framework.

Methods: We searched for published (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Academic Search Complete), and unpublished literature (organ donation organization websites worldwide). Included references discussed the actual and potential impact of organ donation following MAiD on the donation and transplantation system. All references were screened, extracted and analysed by two independent reviewers.

Results: We included 78 references in this review and our finding were summarized across three categories: (1) Impact in the donor pool: (2) statistics on organ donation following MAiD; and (3) potential and actual impact of MAiD on the donation and transplant system.

Conclusions: The potential impact of the MAiD donor on the transplant waiting list is relatively small as this process is still rare, however, due to the current organ shortage worldwide the contribution of this procedure should not be disregarded. Additionally, despite being limited, the existing research provided scanty evidence that organs retrieved from MAiD donors are associated with satisfactory graft function and survival rates and that outcomes from transplant recipients are comparable to those of organs from donation following brain death and may be better than those of organs from other types of donation after circulatory determined death. Still, further studies are required for comprehensive and reliable evidence.

Keywords: Assisted suicide; Euthanasia; Medical assistance in dying; Organ donation; Tissue and organ procurement.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Brain Death
Humans
Organ Transplantation*
Tissue Donors
Tissue and Organ Procurement*