Organ donation after cardiac death in the Middle East.
BACKGROUND
The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool: living donors, split livers, domino livers, and organs from donations after cardiac death (DCD). The purpose of this article was to focus upon aspects of DCD application in the religious, traditional, ethical, and legal aspects of the Arab world.


BACKGROUND
DCD can increase the donor pool by 15%-25%. Several ethical, legal, and social concerns need to be addressed to make DCD more widely accepted by the general population in Western countries as well as in the Middle East. Organs from DCD donors have been transplanted since the 1960s. As soon as brain death criteria were published in 1968, organ retrieval from cadaveric heart-beating donors predominated. Donation after brain death (DBD) almost completely replaced DCD. In the 1990s, the organ shortage led to DCD in many countries, but not in the Arab world. DCD is still not accepted by most in the Arab world due to religious, ethical, social, and legal issues.


CONCLUSIONS
DCD in the Arab world is more complicated than in Western countries. It should be re-evaluated and thoroughly reviewed with the new criteria for DCD and its implementation in our region.
Faraj
W
W
American University of Beirut-Medical Center, Department of Surgery, Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Beirut, Lebanon. wf07@aub.edu.lb
Fakih
H
H
Mukherji
D
D
Khalife
M
M
D018912:Arabs / Q000523:psychology / Q000706:statistics & numerical data; D001926:Brain Death; D002102:Cadaver; D003643:Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004992:Ethics, Medical; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D007883:Legislation, Medical; D008877:Middle East / Q000453:epidemiology; D009927:Tissue and Organ Procurement / Q000592:standards / Q000706:statistics & numerical data*