Reuse of cardiac organs in transplantation

An ethical analysis

Eisuke Nakazawa, Shoichi Maeda, Keiichiro Yamamoto, Aru Akabayashi, Yuzaburo Uetake, Margie H. Shaw, Richard A. Demme, Akira Akabayashi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as "reuse cardiac organ transplantation." Methods: Medical, legal, and ethical analysis, with a main focus on ethical analysis. Results: From the medical perspective, it is critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. Conclusion: We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver.

Original languageEnglish
Article number77
JournalBMC Medical Ethics
Volume19
Issue number1
DOIs
Publication statusPublished - 2018 Aug 17

Fingerprint

Ethical Analysis
Organ Transplantation
Heart Transplantation
organ transplant
recipient
donation
illegality
Hope
recycling
gift
right of ownership
Transplants
Gift Giving
surgery
Ownership
Recycling
Informed Consent
Japan
Nervous System
death

Keywords

  • Ethical aspect
  • Heart transplantation
  • Japan
  • Legal aspect
  • Property right
  • Retransplantation
  • Reuse organ transplantation
  • United States

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health(social science)
  • Health Policy

Cite this

Nakazawa, E., Maeda, S., Yamamoto, K., Akabayashi, A., Uetake, Y., Shaw, M. H., ... Akabayashi, A. (2018). Reuse of cardiac organs in transplantation: An ethical analysis. BMC Medical Ethics, 19(1), [77]. https://doi.org/10.1186/s12910-018-0316-z

Reuse of cardiac organs in transplantation : An ethical analysis. / Nakazawa, Eisuke; Maeda, Shoichi; Yamamoto, Keiichiro; Akabayashi, Aru; Uetake, Yuzaburo; Shaw, Margie H.; Demme, Richard A.; Akabayashi, Akira.

In: BMC Medical Ethics, Vol. 19, No. 1, 77, 17.08.2018.

Research output: Contribution to journalArticle

Nakazawa, E, Maeda, S, Yamamoto, K, Akabayashi, A, Uetake, Y, Shaw, MH, Demme, RA & Akabayashi, A 2018, 'Reuse of cardiac organs in transplantation: An ethical analysis', BMC Medical Ethics, vol. 19, no. 1, 77. https://doi.org/10.1186/s12910-018-0316-z
Nakazawa E, Maeda S, Yamamoto K, Akabayashi A, Uetake Y, Shaw MH et al. Reuse of cardiac organs in transplantation: An ethical analysis. BMC Medical Ethics. 2018 Aug 17;19(1). 77. https://doi.org/10.1186/s12910-018-0316-z
Nakazawa, Eisuke ; Maeda, Shoichi ; Yamamoto, Keiichiro ; Akabayashi, Aru ; Uetake, Yuzaburo ; Shaw, Margie H. ; Demme, Richard A. ; Akabayashi, Akira. / Reuse of cardiac organs in transplantation : An ethical analysis. In: BMC Medical Ethics. 2018 ; Vol. 19, No. 1.
@article{ab2f1741b7c6482daf8c59ffb8850f4f,
title = "Reuse of cardiac organs in transplantation: An ethical analysis",
abstract = "Background: This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as {"}reuse cardiac organ transplantation.{"} Methods: Medical, legal, and ethical analysis, with a main focus on ethical analysis. Results: From the medical perspective, it is critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. Conclusion: We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver.",
keywords = "Ethical aspect, Heart transplantation, Japan, Legal aspect, Property right, Retransplantation, Reuse organ transplantation, United States",
author = "Eisuke Nakazawa and Shoichi Maeda and Keiichiro Yamamoto and Aru Akabayashi and Yuzaburo Uetake and Shaw, {Margie H.} and Demme, {Richard A.} and Akira Akabayashi",
year = "2018",
month = "8",
day = "17",
doi = "10.1186/s12910-018-0316-z",
language = "English",
volume = "19",
journal = "BMC Medical Ethics",
issn = "1472-6939",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Reuse of cardiac organs in transplantation

T2 - An ethical analysis

AU - Nakazawa, Eisuke

AU - Maeda, Shoichi

AU - Yamamoto, Keiichiro

AU - Akabayashi, Aru

AU - Uetake, Yuzaburo

AU - Shaw, Margie H.

AU - Demme, Richard A.

AU - Akabayashi, Akira

PY - 2018/8/17

Y1 - 2018/8/17

N2 - Background: This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as "reuse cardiac organ transplantation." Methods: Medical, legal, and ethical analysis, with a main focus on ethical analysis. Results: From the medical perspective, it is critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. Conclusion: We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver.

AB - Background: This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as "reuse cardiac organ transplantation." Methods: Medical, legal, and ethical analysis, with a main focus on ethical analysis. Results: From the medical perspective, it is critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. Conclusion: We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver.

KW - Ethical aspect

KW - Heart transplantation

KW - Japan

KW - Legal aspect

KW - Property right

KW - Retransplantation

KW - Reuse organ transplantation

KW - United States

UR - http://www.scopus.com/inward/record.url?scp=85051749573&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051749573&partnerID=8YFLogxK

U2 - 10.1186/s12910-018-0316-z

DO - 10.1186/s12910-018-0316-z

M3 - Article

VL - 19

JO - BMC Medical Ethics

JF - BMC Medical Ethics

SN - 1472-6939

IS - 1

M1 - 77

ER -