# New organ transplant rules spark ethics alarm

> The U.S. approves guidelines for a procedure that restarts blood flow in dead donors, but bioethicists say it violates the rule protecting them most.
- Title: New organ transplant rules spark ethics alarm · NPR | Shortify
- Summary: The U.S. approves guidelines for a procedure that restarts blood flow in dead donors, but bioethicists say it violates the rule protecting them most. The U.S.
- Keywords: organ transplants, normothermic regional perfusion, dead donor rule, organ shortage, bioethics, hrsa, optn, transplant surgery, NPR
- Source: NPR — https://npr.org/2026/11/14/nx-s1-6032604/organ-transplant-donor-dead-ethics
- Published: 2026-11-14T00:00:00+00:00
- Read time: 2 min
- Topics: organ transplants, normothermic regional perfusion, dead donor rule, organ shortage, bioethics, hrsa, optn, transplant surgery, news
## U.S. approves first national transplant policy
The organ transplant system approved its first national policy for normothermic regional perfusion, a procedure that restores blood flow to organs after death. Critics say it raises serious ethical concerns.
## How the procedure works
Doctors attach an external pump to a donor minutes after circulation ends and death is declared. The pump restores blood flow to hearts, lungs, kidneys, livers and other organs to prevent deterioration.
## The organ shortage crisis
More than one hundred nine thousand Americans are waiting for an organ transplant. About twelve die every day because of a chronic organ shortage, according to HRSA.
## The Dead Donor Rule violation
Critics say the procedure violates the Dead Donor Rule, which protects donors by requiring organs come only from the dead. Restarting circulation reverses the very condition on which death was declared.

> In order to be dead by circulatory criteria it means we're not going to attempt to reestablish circulation. But that's exactly what they do in NRP.
## Brain reperfusion alarm
Surgeons clamp blood vessels to the head to ensure brain death, but blood appeared to get restored to the brain during some cases. Dr. Claire Morgan reported seeing signs of life in these situations.

> We have seen signs of life in NRP when the brain has been reperfused. It's extremely disturbing.
## New safeguards take effect December sixth
The OPTN board approved guidelines on November sixth requiring surgeons to cut holes in blood vessels to the brain, not just clamp them. The policy takes effect December sixth.
## Critics say safeguards fall short
Most surgeons already clamp and vent blood vessels, critics say. The new policy does not address whether donors are technically dead when organs are removed, raising fundamental unresolved ethical questions.

> I really think the policy is the cart before the horse. The fundamental issues around NRP still remain unresolved.
## Officials defend the new guidelines
Dr. Raymond Lynch of HRSA says the guidelines protect donors and that NRP is ethical and life-saving. He argues it will extend organ supply and improve quality when done properly.

> This is an important first step to make sure NRP care is available but that the safety of the family's loved one is always at the forefront.
## Key takeaway

The U.S. organ transplant system approved its first national policy for normothermic regional perfusion, a procedure that restarts circulation in deceased donors to preserve organs, but critics argue it violates the Dead Donor Rule and raises unresolved ethical concerns.