a prospective study evaluating tHe Feasibility and etHicalperspective oF maastricHt iii organ procurementin FrencH icu patients

Abstract

The Maastricht III procedure consists in performing organ donation in patientsin whom cardiac arrest is consecutive to a decision to withdraw life support.The proposed study is designed to evaluate the possibility of adapting the MIIIprocedure in France by conducting a prospective feasibility study in an Intensivecare Unit (IcU). Within the population of patients for whom a clinical teammeeting decides to withdraw life support, we wanted to determine the time toonset of cardiac arrest following extubation. The duration of this period and thecardiovascular state observed during this period determine the viability of theorgans harvested. We also wanted to determine the incidence and the reasons ofrefusal or consent to organ donation that would be formulated by the familyand/or loved ones if they had been asked to consent to an MIII procedure at thetime of announcement of the clinical team’s decision to withdraw life support.This ethical part of the study will be conducted by two members of the localclinical Ethic Unit, independent of the IcU. This study should be able to determine the time to onset of cardiac arrest afterwithdrawing life support, the time-course of the main clinical andhaemodynamic parameters and the attitude of families and loved ones in relationto this procedure, if it were applied in France. The expected results should helpto define the quantitative impact and feasibility of this procedure on organdonation.