Donation After Circulatory Death (DCD)

Donation after circulatory death (DCD) is defined as organ donation in patients who do not meet brain death criteria/death by neurologic criteria (DNC) and are anticipated to reach asystole within 120 minutes of cessation of artificial support. DCD eligibility is determined prior to formally shifting to comfort care. When authorization for donation is obtained, the donor hero will remain at the hospital to facilitate the recovery of all eligible organs after asystole.

ICU nurses are integral in DCD cases and will continue to provide care to the donor patient from the time of donation authorization up until recovery of organs. MTN clinical coordinators will collaborate with the attending hospital physician on orders to optimize the donation opportunity. When organs have been matched to national waitlist recipients, an extubation/surgical recovery time is coordinated with the hospital OR team, the incoming transplant team and the donor family. The assigned RN accompanies the patient to the location of the planned extubation, where comfort medications will then be administered by the assigned RN. Once asystole has been determined, the RN will likely accompany the patient to the OR where they will hand off to the OR team for the recovery of organs.

DCD is less common than donation after brain death/DNC and occurs in about 35% of MTN’s organ donors. Advancements in DCD may also include the use of normothermic regional perfusion (NRP) to maximize organ outcomes.

Please remember to call MTN on all ventilated patients at 800-366-6791 within 60 minutes or less (per your hospital policy) when your patient meets ANY of the following criteria:

• A severe brain injury OR a devastating illness or,

• A GCS of 5 or less, and

• Any indication a family is shifting toward terminal extubation decisions to preserve the opportunity for donation.

Thank you for your continued support and collaboration to save more lives through donation.