Clinical Outcomes of Organ Transplantation Following Donation After Medical Assistance in Dying: A Systematic Review...

Organ donation after medical assistance in dying (DCD-V) is becoming increasingly common in the few countries where medical-assistance in dying is legalized. While donor warm ischemia time may be shorter compared with controlled donation after circulatory death, the use of high doses of euthanasic drugs could impact posttransplant outcomes. To assess whether DCD-V is a safe and effective method to expand the organ donor pool, it is important to examine the posttransplant results. This systematic review aims to evaluate the outcomes of DCD-V heart, lung, liver, kidney, and pancreatic islets transplantation.

A systematic literature search was conducted in the EMBASE, MEDLINE, Web of Science, and Google Scholar databases for studies reporting clinical outcomes following transplantation with DCD-V grafts. The primary outcome was graft survival.

The search identified 550 studies, of which 19 were included for qualitative and 7 for quantitative analysis. Graft survival rates for DCD-V grafts were comparable to those for controlled donation after circulatory death grafts.

The limited data from this review suggests that DCD-V provides acceptable outcomes and appears safe in lung and kidney transplantation, but caution is warranted in liver transplantation.