Organ donation after circulatory death: an update.
There is an ongoing shortfall of organs for donation in the UK and worldwide. Strategies including donation after circulatory death (DCD), living donation and better identification of potential donors are attempting to increase the number of donors and donated organs. The number of DCD donors in the UK increased by 808% from 37 to 336 between 2001 and 2010 and this is continuing to increase. The most common organs donated from DCD donors are the kidneys, but there is increasing experience of liver, lung and pancreas transplantation. The process of DCD varies between different countries and institutions. The outcome of DCD transplantation has been largely encouraging, particularly for kidneys. The increase in DCD has led to an appraisal of issues that may arise during the donation process; these include the Lazarus phenomenon, the dead donor rule, perimortem interventions, public opinion and conflict of interest for clinicians.
aDepartment of Anaesthesia, Critical Care and Pain Medicine, Western General Hospital bDepartment of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary, Edinburgh, Scotland.
Murray J
MJ
Blackstock
David C
DC
Ray
D003643:Death; 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; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology