Center for Medical Ethics and Health Policy Staff Publications
Language
English
Publication Date
4-1-2026
Journal
American Journal of Transplantation
DOI
10.1016/j.ajt.2025.12.001
PMID
41352611
Abstract
Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of US adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a neutral description of TA-NRP, participants judged its permissibility, reviewed 5 critic and 5 supporter arguments (in random order), and chose which argument they found most convincing. Multivariable logistic regression examined predictors of agreeing with critics. Before exposure to the arguments, 51.5% stated that TA-NRP should be used, 34.2% were uncertain, and 14.4% stated it should not be used. After reviewing arguments, 60.6% agreed with supporters and 39.4% with critics. Two-thirds of those initially uncertain sided with critics. Agreement with critics was associated with religious service attendance, less trust in doctors, nonregistration as an organ donor, and being Black/African American. Participants who agreed with supporters cited TA-NRP's capacity to benefit more patients, whereas those who agreed with critics doubt that donors are irreversibly dead. Although the majority supports TA-NRP, a substantial minority-concentrated among religious, distrustful, and historically underserved participants-remains unconvinced.
Keywords
Humans, Tissue and Organ Procurement, Female, Male, Adult, Middle Aged, Perfusion, United States, Surveys and Questionnaires, Aged, Public Opinion, Tissue Donors, Organ Preservation, ethics and technology, public policy, public trust, thoracoabdominal normothermic regional perfusion, transplant ethics
Published Open-Access
yes
Recommended Citation
Bibler, Trevor M; Robinson, Jill Oliver; Omelianchuk, Adam; et al., "Ethical Controversies in Organ Procurement: A National Survey on Public Perceptions of Thoracoabdominal Normothermic Regional Perfusion" (2026). Center for Medical Ethics and Health Policy Staff Publications. 346.
https://digitalcommons.library.tmc.edu/med_ethics/346