Key Points
Key Points
Î More than 21,000 deceased donor transplants are performed in the United
States each year.
Î Based on 2011 data from the Organ Procurement Transplantation Network,
26% of listed solid organ transplant candidates were too sick to be
transplanted or died while awaiting transplant.
Î The supply of 'traditional' donors after neurological determination of death
is insufficient to provide organs to all patients who might benefit from
transplants.
Î Donation after circulatory determination of death (DCDD) has the potential to
increase the number of deceased donor transplants by roughly 10%.
Î This statement is designed to provide a framework to guide ethics and
health policy considerations in adult and pediatric controlled DCDD from the
perspective of critical care medicine clinicians, transplant subspecialists,
and allocation authorities.
Î This report addresses controlled DCDD. It does not address uncontrolled
DCDD, which refers to donation after an unexpected circulatory arrest.
Consent
Î When patients themselves have consented to organ donation, hospital critical
care and organ procurement organization (OPO) representatives should
respect the patient's donation decision and provide this information to
surrogate decision makers.
Î After clinicians lead discussions with patients or surrogates about the
decisions to withdraw life-sustaining therapies, discussions about DCDD
should proceed promptly and be coordinated by professionals with the
necessary skills to lead such conversations.
Î Consent for DCDD should be obtained by individuals with appropriate
experience and training. These individuals' organizational affiliations should
always be disclosed clearly.
Process