The process of donation after cardiac death: a US perspective

Donation after cardiac death (DCD) has the potential to significantly increase the number of organ donors nationwide by at least 10%, which is the current goal of the National Organ Donation and Transplantation Collaboratives. Several organ procurement organizations in the United States currently exceed this goal with nearly 20% of their organ donors being DCD donors. With the Joint Commission on Accreditation of Healthcare Organizations asking all hospitals in the United States to have a policy on DCD donation, the number of DCD donors nationwide is expected to increase. Likewise, the numbers of organs transplanted from DCD donors is expected to increase since transplantation results with kidneys, pancreata, livers, lungs, and, in two cases, heart transplantation, have been similar to results from brain-dead donors. Equally, if not more important, is the ability to offer the opportunity of organ donation as part of the continuum of care at the end of life for patients and families. The comfort and healing nature of being able to leave a legacy of life through organ donation is well known and should never be underestimated whether donation occurs in the DCD or brain-death setting.