Date: 28 May 2011

Donation after cardiocirculatory death: Back to the future?

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Over the last few decades, we have become accustomed to the principle that organ donation is dependent on the established criteria of brain death, also known as neurologic determination of death (NDD). Much more recently, the “new” concept of organ donation after cardiac or cardiocirculatory death (DCD) has become a source of major debate and discussion amongst transplant physicians, policymakers, and patients. The designation refers to organs that are harvested after death has been declared based on “irreversible cessation of circulatory and respiratory function” rather than based on brain death.1

In fact, DCD is not a new concept; its history goes back to the beginnings of organ transplantation. The debate regarding DCD began very differently when organ transplantation first became a reality over five decades ago. The biologic changes within organs harvested by DCD and the very process of harvesting these organs have been well described in the literature, and the difference between DC ...