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Deceased Donor Organ Donation in the United States: A Review of Current Practices and Future Directions

  • 0Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
The American Surgeon +

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October 22, 2025

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October 22, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Record solid organ transplants in 2023 were boosted by donors after circulatory death (DCD). Newer machine perfusion technologies improve outcomes by reducing ischemia-reperfusion injury (IRI), aiding more patients awaiting transplants.

Area Of Science

  • Transplantation medicine
  • Organ donation science
  • Surgical innovation

Background

  • Despite record solid organ transplants in 2023, donor shortages persist, leaving many patients awaiting life-saving procedures.
  • Donors after circulatory death (DCD) have significantly increased overall transplant numbers.
  • Ischemia-reperfusion injury (IRI) remains a major challenge in organ transplantation, impacting graft survival.

Purpose Of The Study

  • To provide a comprehensive overview of current deceased organ donation practices across all solid organs.
  • To highlight the role of emerging technologies in mitigating IRI and improving organ utilization.
  • To discuss the impact of machine perfusion techniques on transplant outcomes, particularly in higher-risk donors.

Main Methods

  • Review of recent advancements in deceased organ donation protocols.
  • Analysis of the application and outcomes associated with normothermic machine perfusion (NMP), normothermic regional perfusion (NRP), and hypothermic machine perfusion (HMP).
  • Examination of strategies to enhance the utilization of organs from donors after circulatory death (DCD).

Main Results

  • Increased utilization of DCD donors has driven the rise in total solid organ transplants.
  • Machine perfusion technologies (NMP, NRP, HMP) effectively attenuate ischemia-reperfusion injury (IRI).
  • Improved outcomes observed across solid organs, with reduced primary non-function and IRI-related damage, especially in higher-risk donors.

Conclusions

  • Machine perfusion technologies are crucial for improving graft viability assessment and outcomes in solid organ transplantation.
  • Enhanced utilization of DCD donors, supported by advanced perfusion techniques, is key to addressing donor shortages.
  • Current deceased donation practices are evolving to maximize organ availability and patient survival through technological innovation.

Keywords:

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