Donation after cardiac death: lessons learned

Despite the increasingly positive outcome of organ transplantation as an accepted treatment of end-stage organ diseases, an average of 15 people die each day awaiting organ transplantation. According to the United Network for Organ Sharing, there are more than 90,000 people in the United States waiting for an organ transplant. In the United States, less than 1% of all deaths are attributed to brain death. A single brain-dead organ donor has the potential to save up to 8 individuals by donating organs and providing up to 50 people with tissue and cornea transplants. The reality is that the source of available brain-dead donors does not meet the needs of the growing waiting list. To help deal with the increasing demand for organs, donation after cardiac death has been reintroduced to families of patients with catastrophic brain injuries. Families have the right to be informed of all potential end-of-life options, including that of organ donation and the use of donation after cardiac death when appropriate. Hospitals and healthcare workers must be committed to provide the option of donation after cardiac death for both donor families and transplant recipients. The purpose of this article is to examine the process of implementing a donation after cardiac death policy in a 1,061-bed tertiary care hospital with level I trauma designation.