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. 2023 Apr 18;27:144. doi: 10.1186/s13054-023-04432-7

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 2 — Concept map for integrating eCPR and uDCD programs within opt-in organ donation systems. TOR termination of resuscitation; CPR cardiopulmonary resuscitation; ROSC return of spontaneous circulation; ECMO extracorporeal membrane oxygenation; eCPR extracorporeal cardiopulmonary resuscitation via ECMO; DNC death by neurological criteria; DND donation after neurological death; cDCD controlled donation after circulatory death; NRP normothermic regional perfusion of organs via ECMO; uDCD uncontrolled donation after circulatory death. The figure presents a schematic overview of a clinical protocol for eCPR/NRP integration. Ovals designate starting/ending points, rectangles are processes, diamonds are decision points, circles represent uncertainty in outcomes. Critical steps are represented in colors which correspond to summary boxes highlighting prominent ethical and logistical concerns, which are discussed individually at length in the main text