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Division of Medical Ethics Research Transplant Ethics

Transplant Ethics

Researchers in NYU Langone’s Division of Medical Ethics investigate a broad range of ethical and policy issues related to organ transplantation. We are currently involved with the following projects.

Project on the Ethics of Transplant Research on the Newly Deceased

The Division of Medical Ethics is undertaking a project with support from the United Therapeutics Corporation to produce a report on the ethics of using newly deceased persons to test bioengineered lobes of lung for eventual clinical use. The project is led by Arthur L. Caplan, PhD, division director, who has formed a working group composed of members from NYU Langone and other experts from around the United States.

The group is specifically addressing the following questions. Can a body that has been donated for medical research be perfused and ventilated to keep it as close to normal homeostasis as technology allows at an organ procurement organization (OPO) facility? If so, once that status is achieved, can the body be operated on to receive a manufactured lung transplant to determine whether such lungs provide reasonable gas exchange functionality for sustained periods of time—a day, a week, or months?

Additionally, is the same possible with or without specific family consent if the deceased was simply an organ donor without specifying donation for medical research and whose ischemia time has exceeded transplant criteria? If family consent is required, the group will develop an ethically appropriate recommended form of consent for use with the family.

United Therapeutics Corporation is covering the cost of a project working group through a research contract with NYU Langone. A final report will be produced in 2019.

Transplant Ethics Project

Members of the Transplant Ethics Project are researching such topics as organ procurement, fair allocation of organs, ensuring equity in the transplant candidate selection process, living and deceased donor considerations, and transplant financing.

Our activities span all forms of transplant, from solid organ transplant procedures to novel or highly innovative forms of vascularized composite allotransplantation (VCA), including transplant of the face, hand, upper or lower limb, uterus, penis, abdominal wall, and cornea.

Our researchers partner with the world-renowned transplant programs at NYU Langone Transplant Institute and the Hansjörg Wyss Department of Plastic Surgery to establish policies and best practices for the ethics of organ donation and transplant. Recent local and national collaborations have focused on emerging ethical challenges in VCA, the role of public education in willingness to donate for VCA, fairness in transplant eligibility criteria, establishing ethical considerations for penile transplant, recommendations for improving national liver allocation, and understanding patient perceptions of facial transplants.

VIDEO: Dr. Robert Montgomery, director of the NYU Langone Transplant Institute, and Dr. Arthur L. Caplan, director of the Division of Medical Ethics, speak about Dr. Montgomery’s experience as a transplant pioneer, physician, and patient.

Selected Transplant Ethics Project Publications

Kimberly LL … Rodriguez ED. How to integrate lived experience into quality-of-life assessment in patients considering facial transplantation. AMA J Ethics. 2019. DOI.

Parent B … Caplan AL. The ethics of testing and research of manufactured organs on brain-dead/recently deceased subjects. J Med Ethics. 2019. DOI.

McQuinn MW … Rodriguez ED. Self-inflicted gunshot wound as a consideration in the patient selection process for facial transplantation. Camb Q Healthc Ethics. 2019. DOI.

Noel DY … Rodriguez E. Comprehensive assessment of vascularized composite allotransplantation patient-oriented online resources. Ann Plast Surg. 2019. DOI.

Caplan A … Rodriguez E. Emerging ethical challenges raised by the evolution of vascularized composite allotransplantation. Transplantation. 2019. DOI.

Sampson A … Quinn GP. Uterus transplantation in women who are genetically XY. J Med Ethics. 2018. DOI.

Kimberly L and Parent B. Take care when testing manufactured organs on the deceased. J Med Ethics Blog. October 1, 2019.

Cabrera A … Rodriguez E. Perceived esthetic outcomes of face transplantation: A survey of the general public. J Craniofac Surg. 2018. DOI.

Diaz-Siso J … Rodriguez E. Vascularized composite allotransplantation: Alternatives and catch-22s. Plast Reconstr Surg. 2018. DOI.

Plana N … Rodriguez E. The public face of transplantation: The potential of education to expand the face donor pool. Plast Reconstr Surg. 2018. DOI.

Rifkin WJ … Rodriguez ED. Long-distance care of face transplant recipients in the United States. J Plast Reconstr Aes. 2018. DOI.

Cahn-Fuller KL and Parent B. Transplant eligibility for patients with affective and psychotic disorders: A review of practices and a call for justice. BMC Med Ethics. 2017. DOI.

Caplan A and Purves D. A quiet revolution in organ transplant ethics. J Med Ethics. 2017. DOI.

Caplan A … Rodriguez E. The ethics of penile transplantation: Preliminary recommendations. Transplantation. 2017. DOI.

Parent B and Caplan AL. Fair is fair: We must re-allocate livers for transplant. BMC Med Ethics. 2017. DOI.

Kyanko KA … Parent B. Undocumented immigrants face a unique set of risks from tuberculosis treatment: Is this just? AMA J Ethics. 2016;18(3)311–318.