Related Experiment Video
Updated: Aug 7, 2026
Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Donation after cardiac death has a minimal impact on thoracic organ recovery
Leslie Olson1, Lynn Cravero, Jim Kisthard
1LifeCenter Northwest, Bellevue, Wash, USA.
Insights
An aggressive donation after cardiac death (DCD) program significantly increases the organ donor pool. This DCD approach has minimal impact on thoracic organ recovery, offering a vital strategy for addressing organ shortages.
Area of Science:
- Transplantation immunology
- Organ donation and recovery
- Cardiovascular surgery
Background:
- Donation after cardiac death (DCD) programs are expanding, raising concerns about their impact on thoracic organ recovery from non-heart-beating donors.
- Thoracic organs are infrequently recovered from non-heart-beating donors, necessitating an evaluation of DCD's effect on this donor subset.
Purpose of the Study:
- To assess the potential influence of an aggressive donation after cardiac death program on the recovery of thoracic organs.
- To quantify the impact of DCD on the availability of hearts and lungs for transplantation.
Main Methods:
- Retrospective chart review of non-heart-beating donors.
- Evaluation of thoracic organ potential using established criteria for brain-dead donors.
- Analysis of donor management and family consent for organ recovery.
Main Results:
- Out of 44 non-heart-beating donors, 34 (77%) were eligible for abdominal organs only.
- Ten donors (24%) met criteria for thoracic organ donation; however, family decisions limited recovery to 6 potential donors.
- These 6 donors yielded 6 potential hearts and 3 potential lung donors.
Conclusions:
- Aggressive donation after cardiac death programs substantially augment the organ donor pool.
- The potential loss of thoracic organs (6 hearts, 3 lung pairs) is minimal compared to the overall increase in organ recovery.
- DCD programs represent a valuable strategy for increasing organ availability without significantly compromising thoracic organ recovery.
Background:
Our organ procurement organization recently developed an aggressive donation after cardiac death program. Thoracic organs are rarely recovered from non-heart-beating donors. Therefore, there is concern that donation after cardiac death may affect the recovery of thoracic organs from donors not allowed to progress to brain death.
Objective:
To evaluate the potential impact of donation after cardiac death on the recovery of thoracic organs.
Methods:
On the assumption that prolongation of care on all cases would result in a diagnosis of brain death. By retrospective chart review, all donations after cardiac death were evaluated for thoracic organ potential using the same standards that were used to evaluate brain-dead donors.
Results:
During the study period there were 34 of 44 (77%) non-heart-beating donors qualified to donate abdominal organs only. Ten of 44 non-heart-beating donors (24%) qualified to potentially donate thoracic organs; the families of 4 of 10 of these donors insisted on the immediate withdrawal of life support, leaving only 6 donors with thoracic organ potential. All 6 of these donors qualified as potential heart donors and 3 as potential lung donors.
Conclusions:
A total of 97 organs were recovered and successfully transplanted from 44 non-heart-beating donors. If all the donors who qualified to donate thoracic organs progressed to brain death and if their thoracic organs were transplantable, then 6 additional hearts and 3 pairs of lungs may have been recovered. These data demonstrate that an aggressive donation after cardiac death program contributes significantly to the organ donor pool, with a minimal impact on potential thoracic organ recovery.
