Abstract
Donation after circulatory death (DCD) provides the option of organ donation for patients who are not brain-dead, but for whom ventilator support will be removed for the purpose of death. With over 112,000 people waiting for a life-saving transplant, it is crucial that organ procurement organizations determine opportunities for the greatest potential for growth. For many, it is DCD donation. It is possible for DCD donors to donate the liver, kidneys, pancreas, lungs, and even the heart, but the most common organs recovered and transplanted from this donor population remain the liver and kidneys.
Key elements for a successful DCD program within an OPO are public education, hospital development, clear DCD policy creation within the donor hospitals that outlines an efficient referral and DCD process, excellent communication with transplant programs, highly proficient DCD organ recovery, packaging and transport, successful transplantation, and aftercare for the family. Public education should focus on encouraging people to register their donation decision so that their families do not have to make that decision for them. OPOs must provide hospital services personnel to assist hospital staff with the process of identifying patients who could be potential DCD organ donors and educating them on how and when to make the referral. OPOs must also respond to all referrals efficiently and provide the donor hospitals with a high level of service to their patients and families.
A DCD program within an OPO will become successful over time with practice and a significant amount of communication with families, donor hospitals, and transplant programs.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Reiner MA, Cornell D, Howard RJ. Development of a successful non-heart-beating organ donation program. Prog Transplant. 2003;13:225–30.
CMS.gov. Conditions of participation for hospitals. https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/Hospitals.html.
Lewis J, et al. Development of the University of Wisconsin donation after cardiac death evaluation tool. Prog Transplant. 2003;13(4):265–73.
Malinoski DJ, Daly MC, Patel MS, Oley-Graybill C, Foster CE III, Salim A. Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor. J Trauma. 2011;71(4):990–5, discussion 996
Shahed T, et al. Organ donation after cardiac death in amyotropic lateral sclerosis. Ann Neurol. 2012;71(2):154–6.
Institute of Medicine, National Academy of Sciences. Non-heart-beating organ transplantation: practice and protocols. Washington, D.C.: National Academy Press; 2000.
Bernat JL, D’Alessandro AM, Port FK, Bleck TP, Heard SO, Medina J, Rosenbaum SH, Devita MA, Gaston RS, Merion RM, Barr ML, Marks WH, Nathan H, O’connor K, Rudow DL, Leichtman AB, Schwab P, Ascher NL, Metzger RA, Mc Bride V, Graham W, Wagner D, Warren J, Delmonico FL. Report of a National Conference on donation after cardiac death. Am J Transplant. 2006;6:281.
Organ Procurement and Transplant Network policies, updated 05/24/2019, https://optn.transplant.hrsa.gov/governance/policies.
U.S. Public Health Service Guidelines for reducing human immunodeficiency virus, hepatitis B virus, and hepatitis C virus transmission through organ transplantation, Centers for Disease Control and Prevention. MMWR Recomm Rep. 1994; 43(RR-8): 1–17.
Further Reading
Bernat JL, et al. Circulatory death determination in uncontrolled organ donors: a panel viewpoint. Ann Emerg Med. 2014;63(1):89–90.
Grewal HP, et al. Liver transplantation using controlled donation after cardiac death donors: an analysis of a large single-center experience. Liver Transplant. 2009;15:1028–35.
Howard RJ, Cornell D. Ethical Issues in Organ Procurement and Transplantation, Bioethics - Medical, Ethical and Legal Perspectives, Peter A. Clark, IntechOpen, DOI: 10.5772/64922. Available from: https://www.intechopen.com/books/bioethics-medical-ethical-and-legalperspectives/ethical-issues-in-organ-procurement-and-transplantation.
Mathur AK, et al. Donation after cardiac death liver transplantation: predictors of outcome. Am J Transplant. 2010;10:2512–9.
Seem DL, Lee I, Umscheid CA, Kuehnert MJ. PHS guideline for reducing human immunodeficiency virus, hepatitis B virus and hepatitis C virus transmission through organ transplantation. Public Health Reports. 2013;128:247–344.
Sheehy E, Conrad SL, Brigham LE, Luskin R, Eakin M, Schkade L, Hunsicker L. Estimating the number of potential organ donors in the United States. N Engl J Med. 2003;349:667–74.
Taner CB, Bulatao IG, Willingham DL, Perry DK, Sibulesky L, Pungpapong S, Aranda-Michel J, Keaveny AP, Kramer DJ, Nguyen JH. Events in procurement as risk factors for ischemic cholangiopathy in liver transplantation using donation after cardiac death donors. Liver Transpl. 2012;18:101–12.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Balbis, D., Markuson, H. (2020). DCD Liver Transplant: The OPO Perspective. In: Croome, K., Muiesan, P., Taner, C. (eds) Donation after Circulatory Death (DCD) Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-030-46470-7_19
Download citation
DOI: https://doi.org/10.1007/978-3-030-46470-7_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-46469-1
Online ISBN: 978-3-030-46470-7
eBook Packages: MedicineMedicine (R0)