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Donation after circulatory death: the current state and technical approaches to organ procurement
Mohamed F Algahim1, Robert B Love
1Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Insights
Donation after circulatory death (DCD) offers a vital solution to organ shortages, with acceptable early transplant outcomes. Further research is needed to minimize warm ischemia and reperfusion injury in DCD organ procurement.
Area of Science:
- Transplantation Medicine
- Organ Donation
- Surgical Techniques
Background:
- Donation after circulatory death (DCD) is increasingly important due to organ shortages.
- Donation after brain death remains the preferred method, but DCD is gaining traction.
Purpose of the Study:
- To review the current status of DCD.
- To define the DCD donor and outline management protocols.
- To discuss organ procurement techniques for lung and abdominal organs from DCD donors.
Main Methods:
- Literature review of current DCD protocols and techniques.
- Analysis of early outcomes in thoracic and abdominal organ transplantation from DCD donors.
Main Results:
- Acceptable early outcomes have been observed in thoracic and abdominal organ transplants from DCD donors.
- Advancements in surgical techniques and organ preservation are noted.
- Significant challenges remain in minimizing warm ischemia time and reperfusion injury.
Conclusions:
- DCD is regaining importance as a strategy to expand the donor pool.
- Addressing warm ischemia and reperfusion injury is crucial for improving DCD outcomes.
Purpose Of Review:
In this review, we discuss the current state of donation after circulatory death (DCD). We define the DCD donor and describe the current protocols in management of the DCD patient. We then discuss current techniques in organ procurement of the lung and abdominal organs.
Recent Findings:
Although donation after brain death is preferable to DCD, recent data have demonstrated acceptable early outcomes in both thoracic and abdominal organ transplant. In spite of advancements in surgical techniques and organ preservation, much has yet to be learned to minimize warm ischemia time and reperfusion injury in the DCD population.
Summary:
In light of the continually growing disparity between organ supply and demand, DCD has regained traction as a means to increase the donor pool.
