{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T03:06:05Z","timestamp":1767236765265,"version":"3.48.0"},"reference-count":39,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100023194","name":"Canadian Donation and Transplantation Research Program","doi-asserted-by":"crossref","award":["2021 Innovation Grant"],"award-info":[{"award-number":["2021 Innovation Grant"]}],"id":[{"id":"10.13039\/100023194","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,12]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The process of controlled organ donation after circulatory determination of death (cDCDD) results in ischaemic injury to organs and leads to poorer outcomes in organ recipients. Although not yet used in Canada, normothermic regional perfusion (NRP) is a perfusion technology used postmortem with cDCDD donors to selectively restore perfusion of oxygenated blood to target organs in situ, reversing ischaemic injury and improving organ viability and post-transplant outcomes. However, NRP poses significant ethical challenges. To preserve trust in deceased donation, these ethical challenges must be addressed to the satisfaction of Canadian stakeholders before NRP\u2019s implementation. This study will identify ethical issues pertaining to NRP and explore perspectives of NRP among key stakeholders. By developing an explanatory framework delineating how stakeholder perceptions of NRP\u2019s ethical implications impact trust in Canada\u2019s donation and transplantation systems, this study will inform the development of responsible policy on NRP\u2019s use in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      This study includes two workstreams. Workstream 1 is a scoping review of medical and bioethical literature to identify ethical issues stemming from NRP. We will apply a common search string across Medline, PubMed (other than Medline) and Embase to identify relevant articles. We will identify grey literature through Google searches, websites of organ donation organisations and consultation with our research network. No date limits will be applied. All peer-reviewed publications, commentaries, editorials or documents that engage with ethical issues in NRP (or conceptual and empirical issues as they relate to these ethical issues) will be included. News articles, conference abstracts and publications not in English will be excluded. Workstream 2 consists of interviews with healthcare providers, institutional stakeholders, organ recipients and deceased donors\u2019 family members (n=24\u201336), as well as focus groups with healthcare providers involved in deceased donation and transplantation (n\n                      <jats:italic>=<\/jats:italic>\n                      20\u201332). Constructivist grounded theory methodology will guide data collection and analysis in workstream 2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was approved by Western University\u2019s research ethics committee (Western REM; ID: 120001). All participants will be asked to provide written informed consent to participate. Findings will be shared with Canadian organ donation and transplantation organisations, presented at national conferences and published in medical journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-067515","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T11:45:56Z","timestamp":1664451956000},"page":"e067515","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Protocol for a qualitative pilot study to explore ethical issues and stakeholder trust in the use of normothermic regional perfusion in organ donation in Canada"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-9238","authenticated-orcid":false,"given":"Nicholas","family":"Murphy","sequence":"first","affiliation":[{"name":"Philosophy and Medicine, Western University, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorelei","family":"Lingard","sequence":"additional","affiliation":[{"name":"Centre for Education Research and Innovation and Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie","family":"Blackstock","sequence":"additional","affiliation":[{"name":"Donor Family Partner, Almonte, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Ott","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marat","family":"Slessarev","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada"},{"name":"Regional Medical Lead, Trillium Gift of Life Network, Toronto, Ontario, Canada"},{"name":"London Health Sciences Centre, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Basmaji","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, London, Ontario, Canada"},{"name":"Departments of Medicine and Epidemiology & Biostatistics, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayur","family":"Brahmania","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, London, Ontario, Canada"},{"name":"Division of Gastroenterology, Department of Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Healey","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Trillium Gift of Life Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Shemie","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada"},{"name":"Canadian Blood Services, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Skaro","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, London, Ontario, Canada"},{"name":"Department of Surgery, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Wilson","sequence":"additional","affiliation":[{"name":"Canadian Blood Services, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5510-1074","authenticated-orcid":false,"given":"Charles","family":"Weijer","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Epidemiology & Biostatistics, and Philosophy, Western University, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"2025121511035538000_12.9.e067515.1","unstructured":"Canadian Institute for Health Information . Canadian organ replacement register. e-statistics on organ transplants, waiting Lists and donors. Ottawa: ON, 2021. https:\/\/www.cihi.ca\/en\/summary-statistics-on-organ-transplants-wait-lists-and-donors"},{"key":"2025121511035538000_12.9.e067515.2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1503\/cmaj.060895","article-title":"National recommendations for donation after cardiocirculatory death in Canada: donation after cardiocirculatory death in Canada","volume":"175","author":"Shemie","year":"2006","journal-title":"CMAJ"},{"key":"2025121511035538000_12.9.e067515.3","doi-asserted-by":"publisher","DOI":"10.1177\/0885066610396993"},{"key":"2025121511035538000_12.9.e067515.4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00134-020-06341-7","article-title":"Expanding controlled donation after the circulatory determination of death: statement from an international collaborative","volume":"47","author":"Dom\u00ednguez-Gil","year":"2021","journal-title":"Intensive Care 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