Intensive Care Medicine

, Volume 42, Issue 3, pp 305–315 | Cite as

Organ donation in adults: a critical care perspective

  • Giuseppe CiterioEmail author
  • Marcelo Cypel
  • Geoff J. Dobb
  • Beatriz Dominguez-Gil
  • Jennifer A. Frontera
  • David M. Greer
  • Alex R. Manara
  • Sam D. Shemie
  • Martin Smith
  • Franco Valenza
  • Eelco F. M. Wijdicks



The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure.


We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria.


Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques.


Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.


Organ donation Brain death Donation after brain death Donation after circulatory death Intensive care 


Compliance with ethical standards

Conflicts of interest

The authors declare no conflict of interest for this manuscript.

Supplementary material

134_2015_4191_MOESM1_ESM.docx (102 kb)
Supplementary material 1 (DOCX 102 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • Giuseppe Citerio
    • 1
    • 2
    Email author
  • Marcelo Cypel
    • 3
  • Geoff J. Dobb
    • 4
    • 5
  • Beatriz Dominguez-Gil
    • 6
  • Jennifer A. Frontera
    • 7
  • David M. Greer
    • 8
  • Alex R. Manara
    • 9
  • Sam D. Shemie
    • 10
  • Martin Smith
    • 11
    • 12
  • Franco Valenza
    • 13
  • Eelco F. M. Wijdicks
    • 14
  1. 1.School of Medicine and SurgeryUniversity of Milan-BicoccaMilanItaly
  2. 2.Neurointensive Care, Department of Emergency and Intensive CareSan Gerardo HospitalMonzaItaly
  3. 3.Division of Thoracic SurgeryUniversity of TorontoTorontoCanada
  4. 4.Intensive Care UnitRoyal Perth HospitalPerthAustralia
  5. 5.School of Medicine and PharmacologyUniversity of Western AustraliaPerthAustralia
  6. 6.Organización Nacional de TrasplantesMadridSpain
  7. 7.Cerebrovascular Center of the Neurological InstituteCleveland ClinicClevelandUSA
  8. 8.Department of NeurologyYale University School of MedicineNew HavenUSA
  9. 9.The Intensive Care UnitSouthmead Hospital, North Bristol NHS TrustBristolUK
  10. 10.Division of Critical Care, Montreal Children’s HospitalMcGill University Health CentreMontrealCanada
  11. 11.Department of Neurocritical Care, National Hospital for Neurology and NeurosurgeryUniversity College London HospitalsLondonUK
  12. 12.National Institute for Health Research UCLH Biomedical Research CentreLondonUK
  13. 13.Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
  14. 14.Division of Critical Care Neurology, Department of NeurologyMayo ClinicRochesterUSA

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