Organ procurement organizations should develop policy regarding surrogate consent for normothermic regional perfusion
Bibliographic record
Abstract
Normothermic regional perfusion (NRP) is a postmortem technique that restores oxygenated blood flow to transplantable organs in situ after death determination in donation after circulatory death to improve organ viability and function. Although observational evidence strongly suggests NRP is superior to conventional rapid organ recovery, it has generated ethical controversy internationally. While much of the debate revolves around NRP's compatibility with the dead donor rule, an unresolved ethical question facing organ procurement organizations is whether, in addition to general consent (or "authorization") to organ donation, specific consent to NRP should be sought from surrogate decision makers. As NRP practice continues to evolve and as more jurisdictions consider NRP adoption, developing policy governing NRP consent or notification practices should be a priority for organ procurement organizations. In this Personal Viewpoint article, we outline arguments for and against a consent requirement. We conclude that ongoing ethical controversy and unresolved empirical questions concerning the potential for the resumption of intracranial blood flow during NRP support a cautious, consent-based approach at this stage of NRP's adoption.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.211 | 0.283 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.008 | 0.013 |
| Scholarly communication | 0.015 | 0.024 |
| Open science | 0.006 | 0.010 |
| Research integrity | 0.068 | 0.049 |
| Insufficient payload (model declined to judge) | 0.012 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".