Derivation of the Uncontrolled Donation after Circulatory Determination of Death Protocol for New York City |
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| Authors: | S. P. Wall B. J. Kaufman A. J. Gilbert Y. Yushkov M. Goldstein J. E. Rivera D. O’Hara H. Lerner M. Sabeta M. Torres C. L. Smith Z. Hedrington F. Selck K. G. Munjal M. Machado S. Montella M. Pressman L. W. Teperman N. N. Dubler L. R. Goldfrank for the NYC UDCDD Study Group |
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| Affiliation: | 1. Bellevue Hospital Center, New York, NY;2. Department of Emergency Medicine, NYU School of Medicine, New York, NY;3. Fire Department, City of New York, NY;4. Department of Emergency Medicine, Hofstra North Shore ‐ LIJ School of Medicine at Hofstra University, Hempstead, NY;5. NYU Organ Transplant Center, NYU School of Medicine, New York, NY;6. New York Organ Donor Network, New York, NY;7. Department of Surgery, Mount Sinai School of Medicine, New York, NY;8. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;9. Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY;10. New York City Health and Hospitals Corporation, New York, NY;11. Montefiore‐Einstein Bioethics Center, Bronx, NY |
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| Abstract: | Evidence from Europe suggests establishing out‐of‐hospital, uncontrolled donation after circulatory determination of death (UDCDD) protocols has potential to substantially increase organ availability. The study objective was to derive an out‐of‐hospital UDCDD protocol that would be acceptable to New York City (NYC) residents. Participatory action research and the SEED‐SCALE process for social change guided protocol development in NYC from July 2007 to September 2010. A coalition of government officials, subject experts and communities necessary to achieve support was formed. Authorized NY State and NYC government officials and their legal representatives collaboratively investigated how the program could be implemented under current law and regulations. Community stakeholders (secular and religious organizations) were engaged in town hall style meetings. Ethnographic data (meeting minutes, field notes, quantitative surveys) were collected and posted in a collaborative internet environment. Data were analyzed using an iterative coding scheme to discern themes, theoretical constructs and a summary narrative to guide protocol development. A clinically appropriate, ethically sound UDCDD protocol for out‐of‐hospital settings has been derived. This program is likely to be accepted by NYC residents since the protocol was derived through partnership with government officials, subject experts and community participants. |
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| Keywords: | Uncontrolled donation after circulatory determination of death uncontrolled donation after cardiac death qualitative research action research rapid organ recovery deceased organ donation |
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