title: Enabling Donation after Cardiac Death in the Emergency Department: Overcoming Clinical, Legal, and Ethical Concerns.
abstract: BACKGROUND
  In light of the growing gap between candidates for organ donation and the actual number of organs available, we present a unique case of organ donation after cardiac death. We hope to open a discussion regarding organ procurement from eligible donors in the prehospital and emergency department setting.
  
  
  METHODS
  This case study, involving an otherwise healthy man who, after suffering an untimely death, was able to successfully donate his organs, highlights the need to develop an infrastructure to make this type of donation a viable and streamlined option for the future.
  
  
  CONCLUSIONS
  Given the departure from traditional practice in United States transplantation medicine, we bring forth legal and ethical considerations regarding organ donation in the emergency department. We hope that this case discussion inspires action and development in the realm of transplant medicine, with the aim of honoring the wishes of donors and the families of those who wish to donate in a respectful way, while using our medical skills and technologies to afford candidates who are waiting for organs a second chance.
  
  
  CONCLUSIONS
  We believe that this case shows that donation after cardiac death from the emergency department, while resource-intensive is feasible. We recognize that in order for this to become a more attainable goal, additional resources and systems development is required.
authors.affiliation: Department of Emergency Medicine, Albany Medical Center Hospital, Albany, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Dailey
authors.affiliation: Department of Emergency Medicine, Albany Medical Center Hospital, Albany, New York.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Geary
authors.affiliation: Department of Emergency Medicine, Albany Medical Center Hospital, Albany, New York.
authors.forename: Stefan
authors.initials: S
authors.lastname: Merrill
authors.affiliation: Department of Medical Humanities, Davidson College, Davidson, North Carolina.
authors.forename: Marleen
authors.initials: M
authors.lastname: Eijkholt
mesh_terms: D000328:Adult; D003643:Death; D004636:Emergency Service, Hospital / Q000458:organization & administration; D020197:Head Injuries, Penetrating / Q000150:complications; D006801:Humans; D008297:Male; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D014057:Tomography, X-Ray Computed / Q000379:methods; D014481:United States; D014948:Wounds, Gunshot / Q000150:complications
keywords: donation after cardiac death (DCD); organ donation; transplant ethics