title: Current situation of donation after circulatory death in European countries.
abstract: The aim of the present study was to describe the current situation of donation after circulatory death (DCD) in the Council of Europe, through a dedicated survey. Of 27 participating countries, only 10 confirmed any DCD activity, the highest one being described in Belgium, the Netherlands and the United Kingdom (mainly controlled) and France and Spain (mainly uncontrolled). During 2000-2009, as DCD increased, donation after brain death (DBD) decreased about 20% in the three countries with a predominant controlled DCD activity, while DBD had increased in the majority of European countries. The number of organs recovered and transplanted per DCD increased along time, although it remained substantially lower compared with DBD. During 2000-2008, 5004 organs were transplanted from DCD (4261 kidneys, 505 livers, 157 lungs and 81 pancreas). Short-term outcomes of 2343 kidney recipients from controlled versus 649 from uncontrolled DCD were analyzed: primary non function occurred in 5% vs. 6.4% (P = NS) and delayed graft function in 50.2% vs. 75.7% (P < 0.001). In spite of this, 1 year graft survival was 85.9% vs. 88.9% (P = 0.04), respectively. DCD is increasingly accepted in Europe but still limited to a few countries. Controlled DCD might negatively impact DBD activity. The degree of utilization of DCD is lower compared with DBD. Short-term results of DCD are promising with differences between kidney recipients transplanted from controlled versus uncontrolled DCD, an observation to be further analyzed.
authors.affiliation: Organización Nacional de Trasplantes, Madrid, Spain. bdominguez@mspsi.es
authors.forename: Beatriz
authors.initials: B
authors.lastname: Domínguez-Gil
authors.forename: Bernadette
authors.initials: B
authors.lastname: Haase-Kromwijk
authors.forename: Hendrik
authors.initials: H
authors.lastname: Van Leiden
authors.forename: James
authors.initials: J
authors.lastname: Neuberger
authors.forename: Leen
authors.initials: L
authors.lastname: Coene
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Antoine
authors.initials: A
authors.lastname: Corinne
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Muehlbacher
authors.forename: Pavel
authors.initials: P
authors.lastname: Brezovsky
authors.forename: Alessandro Nanni
authors.initials: AN
authors.lastname: Costa
authors.forename: Rafail
authors.initials: R
authors.lastname: Rozental
authors.forename: Rafael
authors.initials: R
authors.lastname: Matesanz
mesh_terms: D001926:Brain Death; D003643:Death; D005060:Europe; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000706:statistics & numerical data; D016035:Pancreas Transplantation / Q000706:statistics & numerical data; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*