Searching for a Solution: A Review of Deceased Donor Solid-Organ Procurement Protocols and Examination of Innovative...

Area of Science:

• Transplantation immunology
• Organ procurement science
• Medical ethics

Background:

• Solid-organ transplant capabilities are advancing, increasing patient reliance on transplants.
• A significant shortage exists for organs from donors following brain death (DBD).
• Organs from donors following circulatory death (DCD) present a comparable alternative to address this shortage.

Purpose of the Study:

• To explore the scientific and philosophical underpinnings of DCD organ procurement.
• To identify potential improvements and standardization strategies for DCD protocols.
• To enhance the yield of viable allografts for transplantation.

Main Methods:

• Review of current DCD organ procurement practices and scientific literature.
• Analysis of the science and philosophy behind DCD donation.
• Discussion of potential protocol enhancements, including life support withdrawal timing and pre-mortem nephrectomy.

Main Results:

• Inconsistent protocols currently govern DCD organ procurement.
• A deeper understanding of the science and philosophy is needed for standardization.
• Standardizing withdrawal of life support and considering pre-mortem nephrectomy may increase allograft yield.

Conclusions:

• Further scientific and community discussion is crucial for DCD procurement.
• Improvements in DCD processes can significantly benefit transplant recipients.
• Standardization efforts hold the potential to expand the donor organ pool.