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Updated: Feb 13, 2026
Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Cost Evaluation of a Donation after Cardiac Death Program: How Cost per Organ Compares to Other Donor Types
Jessica Lindemann1, Leigh Anne Dageforde1, Neeta Vachharajani1
1Department of Surgery, Division of Abdominal Organ Transplantation, Washington University School of Medicine, St Louis, MO.
Insights
Donation after cardiac death (DCD) programs incur significant costs, especially when donors yield no organs. Including all DCD program expenses reveals a nearly 40% increase in the cost per organ compared to initial assessments.
Area of Science:
- Transplantation Medicine
- Organ Procurement
- Healthcare Economics
Background:
- Donation after cardiac death (DCD) is a vital organ donation method, yet over half of evaluated DCD donors do not yield transplantable organs.
- Predictive algorithms for DCD donor suitability are lacking, and comprehensive cost analyses of DCD programs by organ procurement organizations (OPOs) remain unreported.
Purpose of the Study:
- To report the total costs of a DCD program, including donors yielding no organs.
- To compare the costs of DCD donors with those of in-hospital donation after brain death (DBD) donors.
Main Methods:
- Hospital, transportation, and supply costs for potential DCD donors evaluated by a single OPO from 2009 to 2016 were collected.
- Mean costs per donor and per organ were calculated, incorporating costs from donors who did not yield organs.
- DCD donor costs were compared with in-hospital DBD donor costs.
Main Results:
- 289 organs were transplanted from 264 DCD donors. The mean cost per DCD donor yielding organs was $9,306, while 127 donors yielded no organs at a mean cost of $8,794 each.
- The total DCD program cost was $32,020 per donor and $15,179 per organ.
- In-hospital DBD donors cost $33,546 per donor and $9,478 per organ, with a higher organ yield (3.54 vs. 2.21 for DCD).
Conclusions:
- While the mean cost per DCD donor appears comparable to DBD donors, including all program costs increases the cost per DCD organ by nearly 40%.
- The higher organ yield in DBD programs makes the cost per organ significantly lower than in DCD programs.
Background:
Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. Donation after cardiac death program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported.
Study Design:
Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected. Mean costs per donor and per organ were calculated. Cost of DCD donors that did not yield a transplantable organ were included in cost analyses resulting in total cost of the DCD program. Donation after cardiac death donor costs were compared with costs of in-hospital donation after brain death (DBD) donors.
Results:
There were 289 organs transplanted from 264 DCD donors evaluated. Mean cost per DCD donor yielding transplantable organs was $9,306. However, 127 donors yielded no organs, at a mean cost of $8,794 per donor. The total cost of the DCD program was $32,020 per donor and $15,179 per organ. Mean cost for an in-hospital DBD donor was $33,546 and $9,478 per organ transplanted. Mean organ yield for DBD donors was 3.54 vs 2.21 for DCD donors (p < 0.0001), making the cost per DBD organ 63% of the cost of a DCD organ.
Conclusions:
Mean cost per DCD donor is comparable with DBD donors, however, individual cost of DCD organs increases by almost 40% when all costs of an entire DCD program are included.
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