A larger multi-centre study — Neurologic Physiology after Removal of Therapy (NeuPaRT) — is a pivotal advance that is closely studying the neurophysiology of the dying process in the ICU. This panel, with four researchers involved in the NeuPaRT study, will address the scientific and clinical implications from the perspectives of neurology and critical care medicine, organ donation policy, ethics and law.
- Jennifer A. Chandler (organiser, in person)
- Marat Slessarev (in-person)
- Teneille Gofton (in-person)
- Nicholas Murphy (virtual)
Sponsor:
Bertram Loeb Organ & Tissue Donation Institute
Agenda
- Introduction / 5 mins
- Speaker presentations / 25 mins
- Panel discussion / 15 mins
- Q&A & Concluding remarks / 15 mins
Attend
IMT School for Advanced Studies
Guinigi Room
Thursday, April 16, 2026
14:00-15:00 CEST
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Neuroethics 2026
Building Bridges and Cultivating Community
This session is part of the Neuroethics 2026 conference organized by INS and SINe, and hosted by the IMT School for Advanced Studies. Register for the conference to attend in-person at IMT School for Advanced Studies in Lucca, Tuscany, Italy, or to participate virtually.
Description
Death is defined in many parts of the world by the irreversible cessation of circulatory and respiratory functions or by the irreversible cessation of all brain functions. In the context of donation after death determined by circulatory criteria (DCC), death is determined five minutes after circulatory arrest to confirm permanence of circulatory arrest and rule out the possibility of spontaneous resumption of circulation (auto-resuscitation). This approach assumes a crucial and largely untested assumption that brain function stops within that time period.
Emerging research in small single-centre studies is showing that cerebral blood flow and cortical electrical activity often cease before the loss of systemic circulation. A larger multi-centre study – Neurologic Physiology after Removal of Therapy (NeuPaRT) – is a pivotal advance that is closely studying the neurophysiology of the dying process in the ICU. It will provide evidence on the sequencing of loss of brain function and blood flow, and whether these signals resume during potential auto-resuscitation that may occur in the 5 minute observation period after initial circulatory arrest. The results will raise critical ethical and legal questions about when death can be determined. If brain function is irreversibly lost prior to circulatory arrest, could death be declared earlier in donation after DCC? Conversely, if evidence suggests persistence or resumption of brain activity after the five minute waiting period, it could challenge the presumption that donation after DCC is consistent with brain-based definitions of death.
Waiting too long exposes transplantable organs to ischemic-hypoxic damage, reducing the quality of organ grafts and worsening transplant recipient outcomes. On the other hand, declaring death too early threatens donor harm and would violate the dead donor rule – an ethical and legal imperative in deceased organ donation stipulating that death determination must precede organ recovery and that organ recovery cannot be the cause of donor death. This panel presentation by four researchers involved in the NeuPaRT study will address the scientific and clinical implications from the perspectives of neurology and critical care medicine, organ donation policy, ethics and law.
Recording
A recording of this session will be made available to registered attendees.