PURPOSE Cardiac transplantation is a definitive therapy for end-stage heart failure, but demand exceeds supply. Cardiac donation after circulatory determination of death (cardiac DCDD) can be performed using direct procurement and perfusion (DPP), where cardiac activity is restored after heart recovery, or (NRP), where brain blood supply is surgically interrupted, circulation to the thoraco-abdominal organs is restored within the donor's body, followed by heart recovery. While cardiac DCDD would increase the number of heart donors, uptake of programs has been slowed in part because of ethical concerns within the medical community. These debates have been largely devoid of discussion regarding public perceptions. We conducted a national survey of public perceptions regarding cardiac DCDD. METHODS We surveyed 1,001 Canadians about their attitudes towards cardiac DCDD using a rigorously designed and pre-tested survey. RESULTS We found that 843 of 1,001 respondents (84.2%; 95% confidence interval [CI], 81.8 to 86.3) accepted the DPP approach, 642 (64.1%; 95% CI, 61.1 to 67.0) would agree to donate their heart using DPP, and 696 (69.5%; 95% CI, 66.6 to 72.3) would consent to the same for a family member. We found that 779 respondents of 1,001 respondents (77.8%; 95% CI, 75.1 to 80.3) accepted the NRP approach, 587 (58.6%; 95% CI, 55.5 to 61.6) would agree to donate their heart using NRP, and 636 (63.5%; 95% CI, 60.5 to 66.4) would consent to the same for a family member. Most respondents supported the implementation of DPP (738 respondents or 73.7%; 95% CI, 70.9 to 76.3) and NRP (655 respondents or 65.4%; 95% CI, 62.4 to 68.3) in Canada. CONCLUSION The results of this national survey of public attitudes towards cardiac DCDD will inform the implementation of cardiac DCDD programs in a manner that is consistent with public values.

中文翻译：

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循环确定死亡后心脏捐赠的可接受性：对加拿大公众的调查。


目的心脏移植是终末期心力衰竭的最终治疗方法，但供不应求。循环确定死亡后的心脏捐赠（心脏 DCDD）可以使用直接获取和灌注（DPP）进行，其中心脏恢复后心脏活动恢复，或（NRP），其中脑部血液供应通过手术中断，循环至胸腔腹部器官在捐赠者体内恢复，随后心脏也恢复。虽然心脏 DCDD 会增加心脏捐献者的数量，但由于医学界的道德担忧，该计划的实施速度已经放缓。这些辩论很大程度上缺乏有关公众看法的讨论。我们对公众对心脏 DCDD 的看法进行了一项全国调查。方法 我们通过严格设计和预先测试的调查，调查了 1,001 名加拿大人对心脏 DCDD 的态度。结果 我们发现 1,001 名受访者中有 843 名（84.2%；95% 置信区间 [CI]，81.8 至 86.3）接受 DPP 方法，642 名（64.1%；95% CI，61.1 至 67.0）同意使用 DPP 捐献心脏，696 人（69.5%；95% CI，66.6 至 72.3）同意家庭成员也这样做。我们发现，1,001 名受访者中，有 779 名受访者（77.8%；95% CI，75.1 至 80.3）接受 NRP 方法，587 名受访者（58.6%；95% CI，55.5 至 61.6）同意使用 NRP 捐献心脏，636 名受访者（58.6%；95% CI，55.5 至 61.6）同意使用 NRP 捐献心脏。 63.5%；95% CI，60.5 至 66.4）同意家庭成员也这样做。大多数受访者支持在加拿大实施 DPP（738 名受访者或 73.7%；95% CI，70.9 至 76.3）和 NRP（655 名受访者或 65.4%；95% CI，62.4 至 68.3）。 结论 这项全国公众对心脏 DCDD 态度的调查结果将为以符合公众价值观的方式实施心脏 DCDD 计划提供信息。