Donor Procurement Operation in Donation After Circulatory Death Donors

  • David D. LeeEmail author
  • Martin D. Jendrisak


The donor operation in donation after circulatory death (DCD) donors presents unique challenges to the donor hospital staff, organ procurement organization staff, and transplant center team that expose all parties including the liver transplant recipient to challenging risk. Herein, we provide an approach to ensure clear communication, collaborative coordination, and faithful representation of the gift of liver donation in the setting of DCD liver transplantation. In this chapter, we describe the pre-operating room discussion, a detailed description of the modified super-rapid technique as per the Mayo Clinic Florida Protocol, and the critical organ and donation appraisal prior to liver acceptance.


DCD operation Super-rapid technique Asystole-to-cross-clamp Donor warm ischemia time (DWIT) 


  1. 1.
    Casavilla A, Ramirez C, Shapiro R, Nghiem D, Miracle K, Fung JJ, Starzl TE. Experience with liver and kidney allografts from non-heart-beating donors. Transplant Proc. 1995;27:2898.PubMedGoogle Scholar
  2. 2.
    Foley DP, Fernandez LA, Leverson G, Anderson M, Mezrich J, Sollinger HW, D'Alessandro A. Biliary complications after liver transplantation from donation after cardiac death donors: an analysis of risk factors and long-term outcomes from a single center. Ann Surg. 2011;253:817–25.CrossRefGoogle Scholar
  3. 3.
    Foley DP, Fernandez LA, Leverson G, Chin LT, Krieger N, Cooper JT, Shames BD, et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg. 2005;242:724–31.CrossRefGoogle Scholar
  4. 4.
    Mathur AK, Heimbach J, Steffick DE, Sonnenday CJ, Goodrich NP, Merion RM. Donation after cardiac death liver transplantation: predictors of outcome. Am J Transplant. 2010;10:2512–9.CrossRefGoogle Scholar
  5. 5.
    Farid SG, Attia MS, Vijayanand D, Upasani V, Barlow AD, Willis S, Hidalgo E, et al. Impact of donor hepatectomy time during organ procurement in donation after circulatory death liver transplantation: the United Kingdom experience. Transplantation. 2019;103:e79–88.CrossRefGoogle Scholar
  6. 6.
    Taner CB, Bulatao IG, Perry DK, Sibulesky L, Willingham DL, Kramer DJ, Nguyen JH. Asystole to cross-clamp period predicts development of biliary complications in liver transplantation using donation after cardiac death donors. Transpl Int. 2012;25:838–46.CrossRefGoogle Scholar
  7. 7.
    Taner CB, Bulatao IG, Willingham DL, Perry DK, Sibulesky L, Pungpapong S, Aranda-Michel J, et al. Events in procurement as risk factors for ischemic cholangiopathy in liver transplantation using donation after cardiac death donors. Liver Transpl. 2012;18:100–11.CrossRefGoogle Scholar
  8. 8.
    Mehta C, Brady W. Pulseless electrical activity in cardiac arrest: electrocardiographic presentations and management considerations based on the electrocardiogram. Am J Emerg Med. 2012;30:236–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of SurgeryLoyola University Medical CenterMaywoodUSA
  2. 2.Gift of Hope Organ & Tissue Donor NetworkItascaUSA

Personalised recommendations