The Dead Donor Rule and Normothermic Regional Perfusion

Normothermic regional perfusion (NRP) can be used after the circulatory determination of death to prevent or minimize organ damage before the donor's organs are retrieved. It involves restarting circulation within the donor's body to reperfuse abdominal and thoracic organs while occluding the arteries that supply oxygenated blood to the brain to prevent brain recirculation and the possible restoration of brain function. Yet there are many who object to the use of NRP. These critics claim that donation with NRP, unlike standard deceased donation, violates the dead donor rule. However, when we examine their arguments for this claim, we find that those or similar arguments apply with equal force to standard deceased donation. Critics of NRP have therefore insufficiently appreciated the implications of their criticisms for the other deceased donation practices that they defend. Either all deceased donation practices violate the dead donor rule, or none of them do.