title: The case against imminent death donation.
abstract: OBJECTIVE
  Imminent death donation (IDD) is a proposal to procure organs from patients prior to the withdrawal of life support, which is anticipated to lead to death. In this review, we outline substantial concerns that the transplant community should consider when deliberating the possibility of practicing IDD.
  
  
  RESULTS
  Although there are several compelling theoretical and intuitive reasons to support IDD, its application has been hindered because of inadequate definitions or protocols. A lack of published reports limits empirical data about the practice. Discussion on the topic has not adequately addressed potential harms to the donor, involvement of stakeholders, or the threat to public trust.
  
  
  CONCLUSIONS
  Although IDD has been proposed as a method to increase the number of organs or improve end-of-life care, the proposal currently poses more risk than benefit for patients and the transplant community. Until the major barriers to implementation of IDD are addressed, the transplant community should invest its efforts to increase the organ supply elsewhere.
authors.affiliation: aDepartment of Surgery, Hospital of the University of Pennsylvania bDepartment of Medical Ethics and Health Policy cRenal-Electrolyte and Hypertension Division, Department of Medicine, Hospital of the University of Pennsylvania dCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Lee
authors.forename: Vishnu S
authors.initials: VS
authors.lastname: Potluri
authors.forename: Peter P
authors.initials: PP
authors.lastname: Reese
mesh_terms: D003643:Death; D006801:Humans; D013727:Terminal Care / Q000592:standards*; D009927:Tissue and Organ Procurement / Q000379:methods*