Optimizing Organ Donation After Euthanasia: A Critical Appraisal
This Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ qual...
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| Format: | Article |
| Language: | English |
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MDPI AG
2025-04-01
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| Series: | Transplantology |
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| Online Access: | https://www.mdpi.com/2673-3943/6/2/10 |
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| author | E. A. J. Alkemade H. D. Lam B. J. C. Hendriks A. E. Braat I. P. J. Alwayn M. J. Coenraad A. G. Baranski |
| author_facet | E. A. J. Alkemade H. D. Lam B. J. C. Hendriks A. E. Braat I. P. J. Alwayn M. J. Coenraad A. G. Baranski |
| author_sort | E. A. J. Alkemade |
| collection | DOAJ |
| description | This Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ quality. This study evaluates existing euthanasia protocols in the Netherlands, Belgium, Spain, and Canada, focusing on differences in the medication types and dosages. Additionally, a literature review assessed the potential hepatotoxic effects of high-dose medications like thiopental, propofol, and non-depolarizing neuromuscular blocking agents. High doses of non-depolarizing neuromuscular blocking agents, particularly rocuronium, are associated with hepatotoxic effects in vitro. Furthermore, thiopental doses exceeding 750 mg significantly increase the risk of liver dysfunction. Recent findings also indicate that high-dose propofol and lidocaine can slightly prolong the time to death, which is crucial for optimizing organ viability in ODE. This study highlights the need to optimize organ donation procedures after euthanasia. Further research is needed to achieve this balance, maintaining the integrity and ethical standards of the euthanasia process while enhancing the outcomes of organ donation. |
| format | Article |
| id | doaj-art-dbf86347c5d34ce2a6afb5ddb6bee256 |
| institution | Kabale University |
| issn | 2673-3943 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Transplantology |
| spelling | doaj-art-dbf86347c5d34ce2a6afb5ddb6bee2562025-08-20T03:26:53ZengMDPI AGTransplantology2673-39432025-04-01621010.3390/transplantology6020010Optimizing Organ Donation After Euthanasia: A Critical AppraisalE. A. J. Alkemade0H. D. Lam1B. J. C. Hendriks2A. E. Braat3I. P. J. Alwayn4M. J. Coenraad5A. G. Baranski6Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsAbdominal Organ Transplant Centre, Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Clinical Pharmacy and Toxicology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsAbdominal Organ Transplant Centre, Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsAbdominal Organ Transplant Centre, Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Gastroenterology and Hepatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsAbdominal Organ Transplant Centre, Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsThis Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ quality. This study evaluates existing euthanasia protocols in the Netherlands, Belgium, Spain, and Canada, focusing on differences in the medication types and dosages. Additionally, a literature review assessed the potential hepatotoxic effects of high-dose medications like thiopental, propofol, and non-depolarizing neuromuscular blocking agents. High doses of non-depolarizing neuromuscular blocking agents, particularly rocuronium, are associated with hepatotoxic effects in vitro. Furthermore, thiopental doses exceeding 750 mg significantly increase the risk of liver dysfunction. Recent findings also indicate that high-dose propofol and lidocaine can slightly prolong the time to death, which is crucial for optimizing organ viability in ODE. This study highlights the need to optimize organ donation procedures after euthanasia. Further research is needed to achieve this balance, maintaining the integrity and ethical standards of the euthanasia process while enhancing the outcomes of organ donation.https://www.mdpi.com/2673-3943/6/2/10euthanasiaorgan donationorgan transplantationpharmacokineticspharmacodynamicshepatotoxicity |
| spellingShingle | E. A. J. Alkemade H. D. Lam B. J. C. Hendriks A. E. Braat I. P. J. Alwayn M. J. Coenraad A. G. Baranski Optimizing Organ Donation After Euthanasia: A Critical Appraisal Transplantology euthanasia organ donation organ transplantation pharmacokinetics pharmacodynamics hepatotoxicity |
| title | Optimizing Organ Donation After Euthanasia: A Critical Appraisal |
| title_full | Optimizing Organ Donation After Euthanasia: A Critical Appraisal |
| title_fullStr | Optimizing Organ Donation After Euthanasia: A Critical Appraisal |
| title_full_unstemmed | Optimizing Organ Donation After Euthanasia: A Critical Appraisal |
| title_short | Optimizing Organ Donation After Euthanasia: A Critical Appraisal |
| title_sort | optimizing organ donation after euthanasia a critical appraisal |
| topic | euthanasia organ donation organ transplantation pharmacokinetics pharmacodynamics hepatotoxicity |
| url | https://www.mdpi.com/2673-3943/6/2/10 |
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