title: Making a case for controlled organ donation after cardiac death: the story of Italy's first experience.
abstract: Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process. In our case, the death of the patient subsequent to the withdrawal of life-sustaining therapies was consistent with the patient's wishes, showing respect for his dignity and honoring his autonomy, as expressed to his family previously. By making donation possible, the medical team was able to fulfill the family's last request on behalf of the patient. This case should stimulate deliberation regarding the potential to shorten the 20-minute no-touch period currently in place in Italy. Such an action would not have injured this patient and would certainly have increased the quality of the procured organs.
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy. Electronic address: m.vergano@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Vergano
authors.affiliation: Imperial College London, St. Mary's Hospital, London, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Magavern
authors.affiliation: Scuola di Specializzazione in Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Torino, Torino, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Baroncelli
authors.affiliation: Scuola di Specializzazione in Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Torino, Torino, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Frisenda
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Fonsato
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Artusio
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Castioni
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: De Piero
authors.affiliation: SSD Trapianto di Rene, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Abelli
authors.affiliation: SSD Trapianto di Rene, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Ticozzelli
authors.affiliation: SC Anestesia e Rianimazione, Ospedale Torino Nord Emergenza S. Giovanni Bosco, Torino, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Livigni
mesh_terms: D003422:Critical Care; D003643:Death; D003657:Decision Making; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009927:Tissue and Organ Procurement
keywords: Death declaration; Death definition; Intensive care unit; Kidney transplantation; Normothermic regional perfusion; Organ donation after circulatory declaration of death; Withdrawal of life support