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Accepted Paper:

Uncertainties around mechanical circulatory support provided by ventricular assistance and the heart transplants  
Marisol Marini (Universidade de São Paulo)

Paper short abstract:

This work explores what the mechanical circulatory support is creating in American institutions and in a Brazilian laboratory. I will argue that in the American context, where scientists are proposing eligibility criteria for transplant, more than devices, concepts are being created.

Paper long abstract:

In the 1970s, technologies for mechanical circulatory support emerged as an alternative to prolong the life of patients who need to replace the "native" organ. Until now, there are not enough organs available to be transplanted, so the main purpose of these devices is to provide survival to patients. According to American researchers however, mechanical circulatory support was developed as a therapy for end-stage heart failure when heart transplantation was not yet a useful treatment modality (because the introduction of cyclosporine, which has enabled the increasing success of heart transplantation, has occurred only in the 1980s). That means that the mechanical circulatory support was preceding to heart transplantation. In fact, since the first heart-lung machine used in open-heart surgeries, the use of artificial devices changed the death concept (now considered as brain death), which made possible to replace human hearts. More than change the life and death concept, howev

er, the wider production and use of mechanical devices now can change the conceptions about how to distribute organs to patients on the waiting list. According to these Americans researchers, considering the Intermacs database, it is possible to identify limiting factors and risk factors. Hence, from the data produced by research with artificial devices it is possible to create a profile of patients and establish who is the most suitable to receive artificial devices or human organs. This work aims to understand what is being created along with mechanical devices and explore the ethical questions related to heart transplantation.

Panel P110
Anticipatory knowledge: prognostics and prophecy in management and governance
  Session 1