title: Critical appraisal of organ procurement under Maastricht 3 condition.
abstract: The ethics committee of the French Society of Anesthesia and Intensive Care (Sfar) has been requested by the French Biomedical Agency to consider the issue of organ donation in patients after the decision to withdraw life-supportive therapies has been taken. This type of organ donation is performed in the USA, Canada, the United Kingdom, the Netherlands and Belgium. The three former countries have published recommendations formalizing procedures and operations. The French Society of Anesthesia and Intensive Care (Société française d'anesthésie et de reanimation [Sfar]) ethics committee has considered this issue and envisioned the different aspects of the whole process. Consequently, it sounded a note of caution regarding the applicability of this type of organ procurement in unselected patients following a decision to withdraw life-supportive therapies. According to French regulations concerning organ procurement in brain-dead patients, the committee stresses the need to restrict this specific way of procurement to severely brain-injured patients, once confirmatory investigations predicting a catastrophic prognosis have been performed. This suggests that the nature of the confirmatory investigation required should be formalized by the French Biomedical Agency on behalf of the French parliamentarians, which should help preserve population trust regarding organ procurement and provide a framework for medical decision. This text has been endorsed by the Sfar.
authors.affiliation: Unité de neuro-anesthésie-réanimation, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
authors.forename: L
authors.initials: L
authors.lastname: Puybasset
authors.affiliation: Département d'anesthésie-réanimation, Hôtel-Dieu, boulevard Léon-Malfreyt, BP 69, 63003 Clermont-Ferrand cedex, France.
authors.forename: J-E
authors.initials: JE
authors.lastname: Bazin
authors.affiliation: Service d'anesthésie-réanimation, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Beloucif
authors.affiliation: Département-service d'anesthésie-réanimation, hôpital Laënnec, CHU de Nantes, boulevard Jacques-Monod, BP 1005, 44093 Nantes cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Bizouarn
authors.affiliation: Service de neurologie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
authors.forename: S
authors.initials: S
authors.lastname: Crozier
authors.affiliation: Service de médecine palliative, centre hospitalier René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France.
authors.forename: B
authors.initials: B
authors.lastname: Devalois
authors.affiliation: Département d'anesthésie-réanimation, hôpital Sainte-Marguerite, BP 29, 13274 Marseille cedex 9, France.
authors.forename: B
authors.initials: B
authors.lastname: Eon
authors.affiliation: Département d'anesthésie-réanimation, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75745 Paris cedex 10, France.
authors.forename: F
authors.initials: F
authors.lastname: Fieux
authors.affiliation: Centre de sociologie des organisations, 19, rue Amélie, 75007 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Gisquet
authors.affiliation: Centre Maurice-Halbwachs-CNRS, 48, boulevard Jourdan, 75014 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Guibet-Lafaye
authors.affiliation: Groupe de recherche FAMIREA, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75745 Paris cedex 10, France.
authors.forename: N
authors.initials: N
authors.lastname: Kentish
authors.affiliation: Département d'anesthésie-réanimation, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: A
authors.initials: A
authors.lastname: Lienhart
authors.affiliation: Département d'anesthésie-réanimation, hôpital de la Pitié-Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Nicolas-Robin
authors.affiliation: Département d'anesthésie-réanimation, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75908 Paris cedex 15, France.
authors.forename: M
authors.initials: M
authors.lastname: Otero Lopez
authors.affiliation: Département de philosophie, université de Poitiers, 36, rue de la Chaîne, 86022 Poitiers, France.
authors.forename: C
authors.initials: C
authors.lastname: Pelluchon
authors.affiliation: Département d'anesthésie-réanimation, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75745 Paris cedex 10, France.
authors.forename: F
authors.initials: F
authors.lastname: Roussin
authors.affiliation: Pôle d'anesthésie-réanimation, centre hospitalier universitaire, 4, rue Larrey, 49033 Angers cedex 01, France. Electronic address: lbeydon.angers.@invivo.edu.
authors.forename: L
authors.initials: L
authors.lastname: Beydon
mesh_terms: D060666:Airway Extubation; D001926:Brain Death; D001930:Brain Injuries; D002908:Chronic Disease; D003422:Critical Care; D003643:Death; D005602:France; D006323:Heart Arrest; D006801:Humans; D002534:Hypoxia, Brain; D008020:Life Support Care / Q000331:legislation & jurisprudence / Q000592:standards; D011379:Prognosis; D012128:Respiratory Distress Syndrome; D020521:Stroke; D014019:Tissue Donors / Q000145:classification*; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000592:standards; D028761:Withholding Treatment / Q000331:legislation & jurisprudence
keywords: Limitation des soins; Prélèvements d’organes; Tissue and organ procurement; Withholding treatment