*Purpose: The most promising innovations for overcoming the organ shortage include novel organ sources such as xenotransplant and bioengineered organs. Studying these organs in mechanically supported recently deceased (hereafter MSRD) is valuable for translational research and avoids unnecessary risk to living human subjects; however, this research model bears unique ethical considerations.

*Methods: Multidisciplinary review of preliminary MSRD research identified the following ethics challenges. First, systems for subject recruitment are lacking, in part due to necessary prioritization of organ transplantation. Only after families authorize donation and organs are determined unsuitable for transplant is transplant research broached. This delay and the desire to lay the deceased to rest can cause families to decline. Attempted allocation of marginal organs without accepting centers can also prevent MSRD research. Second, ethical authorization needs to be defined. Most people who authorize organ donation do not cognize transplant research, so it is unclear whether donation registration is a valid proxy for research authorization. It must be decided whether first-person authorization (FPA) is necessary, sufficient, or neither to proceed with MSRD research. If families are approached, they must be given morally relevant information without being unduly burdened during a traumatic time. Third, the utilization of resources for MSRD research will need to be just. If MSRD research is integrated into clinical care facilities, this could cause public concern regarding safety and the prioritization of acute care.

*Results: Close coordination with the regional organ procurement organization is critical to avoid delay in the authorization approach and to ensure consistent communication with decision makers. Closest relations should be approached to ensure research is consistent with the deceased’s values regardless of first-person authorization. Morally relevant information might include whether the research involves nonhuman animal parts, how long the body will be used, whether the body can be returned, and what it might look like when returned. Information must be disclosed in conversation with a study team member in a manner designed to encourage further inquiry. MSRD research must not strain acute care resources and should take place in dedicated facilities.

*Conclusions: Additional empirical ethics research is necessary to better understand public awareness and acceptance of MSRD research.

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