Honarmand Kimia, Ball Ian, Meade Maureen O, Sarti Aimee J, Paleczny Sydni, LeBlanc Danielle, Basmaji John, Belley-Côté Emilie P, Chassé Michaël, D'Aragon Fred, Guyatt Gordon, Rochwerg Bram, Shemie Sam D, Sibbald Robert, Slessarev Marat, Weiss Mathew J, Parsons Leigh Jeanna
Division of Critical Care, Department of Medicine, Mackenzie Health, Vaughan, ON, Canada.
Cortellucci Vaughan Hospital, 3200 Major Mackenzie Drive West, Vaughan, ON, L6A 4A3, Canada.
Can J Anaesth. 2025 Jul 15. doi: 10.1007/s12630-025-02998-0.
Cardiac donation after death determination by circulatory criteria (DCC) can be performed using either direct procurement and perfusion (DPP) or normothermic regional perfusion (NRP). If broadly implemented in Canada, these procedures have the potential to reduce the cardiac transplant wait list. We aimed to evaluate the perspectives of Canadians on cardiac DCC.
We performed a convergent design mixed methods study involving 21 focus groups and surveys of 109 adults in Canada on the topic of cardiac DCC.
We found that participants were broadly supportive of both cardiac DCC protocols. Principle concerns about DPP included relatively impaired heart quality, while concerns about NRP included the perception that the procedure may be invasive and may not be acceptable to other Canadians, including donor families. Participants who self-identified as second-generation immigrants were concerned about potential lack of support for cardiac DCC, especially NRP, by other Canadians. Participants suggested strategies to increase support for organ donation and cardiac DCC specifically, including mass media campaigns, educational initiatives, encouraging the public to discuss end-of-life wishes with family members, and enlisting primary care providers and community leaders to advance public knowledge and support.
In this mixed methods study of people living in Canada, we found broad support for cardiac DCC. Concerns were primarily related to heart quality in DPP and perceived invasiveness of NRP. Participants identified mass media campaigns, educational material, and engagement of primary care providers and community leaders as strategies to garner support for cardiac DCC.
根据循环标准判定死亡后的心脏捐赠（DCC）可采用直接获取与灌注（DPP）或常温区域灌注（NRP）。若在加拿大广泛实施，这些程序有可能减少心脏移植等待名单。我们旨在评估加拿大人对心脏DCC的看法。
我们开展了一项采用收敛性设计的混合方法研究，涉及21个焦点小组，并对109名加拿大成年人进行了关于心脏DCC主题的调查。
我们发现参与者普遍支持这两种心脏DCC方案。对DPP的主要担忧包括心脏质量相对受损，而对NRP的担忧包括认为该程序可能具有侵入性，且可能不为包括捐赠者家属在内的其他加拿大人所接受。自我认定为第二代移民的参与者担心其他加拿大人可能对心脏DCC，尤其是NRP缺乏支持。参与者提出了具体增加对器官捐赠和心脏DCC支持的策略，包括大众媒体宣传活动、教育倡议、鼓励公众与家庭成员讨论临终愿望，以及争取初级保健提供者和社区领袖以增进公众了解和支持。
在这项针对加拿大居民的混合方法研究中，我们发现对心脏DCC普遍支持。担忧主要与DPP中的心脏质量以及NRP的感知侵入性有关。参与者确定大众媒体宣传活动、教育材料以及初级保健提供者和社区领袖的参与是获得对心脏DCC支持的策略。
