Donation After Circulatory Determination of Death

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  • DCD Outcomes
  • DCD Policies

    Hospital Policy Examples

    OPO Policy Examples

    • DCD Procedure OPO PolicydownloadGift of Hope
  • Educational Tools

    Algorithm & Flowcharts

    • Donation After Cardiac Death Flowchart – download – Gift of Life Michigan

    Uncontrolled DCD

    • Protocols for Uncontrolled Donation after Circulatory Death: A Systematic Review of International Guidelines, Practices and Transplant Outcomesarticle – Ortega-Deballon I, Hornby L, Shemie SD. (2015), Crit Care, 19: 268. doi: 10.1186/s13054-015-0985-7.
  • Ethics on DCD
  • FAQ for Hospital Staff and Donor Families
    • DCD Brochure for Hospitals – download – Gift of Hope
  • OR Flowsheets and Set Up

    OR Flowsheets

    • DCD Post-Extubation Data Tracking Sheetdownload – Gift of Hope

    OR Setup

  • Archive

    DCD Outcomes

    Donation Rate

    • Estimated Supply of Organ Donors After Circulatory Determination of Death: A Population-Based Cohort Study – article – Halpern SD, Barnes B, Hasz RD, et al. (2010), JAMA, 304(23): 2592-2594. doi: 10.1001/jama.2010.1824. 


    • Cold Machine Perfusion Versus Static Cold Storage of Kidneys Donated After Cardiac Death: A UK Multicenter Randomized Controlled Trial – article – Watson CJ, Wells AC, Roberts RJ, et al. (2010), AM J Transplant, 10(9): 1991-1999. doi: 10.1111/j.1600-6143.2010.03165.x.
    • Machine Perfusion Versus Cold Storage for the Preservation of Kidneys Donated After Cardiac Death – article – Jochmans I, Moers C, Smits JM, et al. (2010), Ann Surg, 252(5): 756-764. doi: 10.1097/SLA.0b013e3181ffc256.
    • Short- and Long-Term Outcomes with the Use of Kidneys and Livers Donated after Cardiac Death – article – Doshi MD, Hunsicker LG. (2007), Am J Transplant, 7(1): 122-129. Epub 2006 Oct 25.


    • A Comprehensive Risk Assessment of Mortality Following Donation after Cardiac Death Liver Transplant – An Analysis of the National Registry – article – Jay C, Ladner D, Wang E, et al. (2011), J Hepatol, 55(4): 808-813. doi: 10.1016/j.jhep.2011.01.040. Epub 2011 Feb 19.
    • Biliary Complications After Liver Transplantation From Donation After Cardiac Death Donors: An Analysis of Risk Factors and Long Term Outcomes from a Single Centerarticle – Foley DP, Fernandez LA, Leverson G, et al. (2011), Ann Surg, 253(4): 817-825. doi: 10.1097/SLA.0b013e3182104784.
    • Donation after Cardiac Death Liver Transplantation: Predictors of Outcome – article – Mathur AK, Heimbach J, Steffick DE, et al. (2010), Am J Transplant, 10(11): 2512-2519. doi: 10.1111/j.1600-6143.2010.03293.x.
    • Ischemic Cholangiopathy After Controlled Donation After Cardiac Death Liver Transplantation A Meta-analysis – article – Jay CL, Lyuksemburg V, Ladner DP, et al. (2011), Ann Surg, 253(2): 259-264. doi: 10.1097/SLA.0b013e318204e658.


    • Donation after Cardiac Death Lung Transplantation Outcomes – article – Wigfield CH, Love RB. (2011), Curr Opin Organ Transplant, 16(5): 462-468. doi: 10.1097/MOT.0b013e32834a99ac.
    • Donation after Cardiac Death: A 29-Year Experience – article – Bellingham JM, Santhanakrishnan C, Neidlinger N, et al. (2011), Surgery, 150(4): 692-702. doi: 10.1016/j.surg.2011.07.057.
    • Lungs from Donation after Circulatory Death Donors: An Alternative Source to Brain-Dead Donors? Midterm Results at a Single Institution – article – Zych R, Popov AF, Amrani M, et al. (2012), Eur J Cardiothorac Surg. doi: 10.1093/ejcts/ezs096.


    • Islet Transplantation Using Donors After Cardiac Death: Report of the Japan Islet Transplantation Registry – article – Saito T, Gotoh M, Satomi S, et al. (2010), Transplantation, 90(7): 740-747. doi: 10.1097/TP.0b013e3181ecb044.
    • Outcomes of Pancreas Transplantation in the United States Using Cardiac-Death Donors – article – Salvalaggio PR, Davies DB, Fernandez LA, Kaufman DB. (2006), Am J Transplant, 6(5 Pt 1): 1059-1065.
    • Outcomes of Simultaneous Pancreas–Kidney Transplantation from Brain Dead and Controlled Circulatory Death Donors – article – Fernandez LA, Di Carlo A, Odorico JS, et al. (2005), Ann Surg, 242(5): 716-723. doi: 10.1097/01.sla.0000186175.84788.50

    DCD Policies


    • DCD EISOR Standard of Practice – download – Henry Ford Health System, IL
    • DCD Hospital Policydownload – Henry Ford Health System, IL
    • Hospital Clinical DCD Policydownload – Spectrum Health, MI
    • Policies on Donation After Cardiac Death at Children’s Hospitals A Mixed-Methods Analysis of Variation – article – Antommaria AH, Trotochaud K, Kinlaw K, et al. (2009), JAMA, 301(18): 1902-1908. doi: 10.1001/jama.2009.637.
    • The Impact of Variation in Donation After Cardiac Death Policies Among Donor Hospitals: A Regional Analysis – article – Rhee JY, Ruthazer R, O’Connor K, et al. (2011), AM J Transplant, 11(8): 1719-1726. doi: 0.1111/j.1600-6143.2011.03634.x. Epub 2011 Jul 12.

    Educational Tools

    Algorithm & Flowcharts

    • Donation After Cardiac Death Algorithm – download – OneLegacy
    • Donation After Cardiac Death Process Algorithm – download – Hurley Medical Center
    • ASTS Recommended Practice Guidelines for Controlled Donation after Cardiac Death Organ Procurement and Transplantationarticle – Reich DJ, Mulligan DC, Abt PL, et al; ASTS Standards on Organ Transplantation Committee. (2009) Am J Transplant, 9(9): 2004-2011. doi: 10.1111/j.1600-6143.2009.02739.x. Epub 2009 Jul 16.

    Death Progression

    • Development of the University of Wisconsin donation After Cardiac Death Evaluation Tool – article – Lewis J, Peltier J, Nelson H, et al. (2003), Prog Transplant, 13(4): 265-273.
    • External Validation of a Prognostic Model Predicting Time of Death after Withdrawal of Life Support in Neurocritical Patients – article – de Groot YJ, Lingsma HF, Bakker J, et al. (2012), Crit Care Med, 40(1): 233-238. doi:  10.1097/CCM.0b013e31822f0633.
    • Prediction of Time of Death after Withdrawal of Life-Sustaining Treatment in Potential Donors after Cardiac Death – article – Wing J, Snoeijs MG, Brugman CA, et al. (2012), Crit Care Med, 40(3): 766-769. doi: 10.1097/CCM.0b013e318232e2e7.
    • Time to Cardiac Death After Withdrawal of Life-Sustaining Treatment in Potential Organ Donors – article – Suntharalingam C, Sharples L, Dudley C, et al. (2009), Am J Transplant, 9(9): 2157-2165. doi: 10.1111/j.1600-6143.2009.02758.x. Epub 2009 Jul 22.

    Graft Failure

    • A Comprehensive Risk Quantification Score for Deceased Donor Kidneys: The Kidney Donor Risk Index – article – Rao PS, Schaubel DE, Guidlinger MK, et al. (2009), Transplantation, 88(2): 231-236. doi: 10.1097/TP.0b013e3181ac620b.
    • A Simplified Donor Risk Index for Predicting Outcome After Deceased Donor Kidney Transplantation – article – Watson CJ, Johnson RJ, Birch R, et al. (2012), Transplantation, 93(3): 314-318. doi: 10.1097/TP.0b013e31823f14d4.
    • Characteristics Associated with Liver Graft Failure: The Concept of a Donor Risk Index – article – Feng S, Goodrich NP, Bragg-Gresham JL, et al. (2006), Am J Transplant, 6(4): 783-790.
    • Liver Transplantation Using Organ Donation After Cardiac Death: A Clinical Predictive Index for Graft Failure-Free Survival – article – Hong JC, Yersiz H, Kositamongkol P, et al. (2011), Arch Surg, 146(9): 1017-1023. doi: 10.1001/archsurg.2011.240.
    • Systematic Evaluation of Pancreas Allograft Quality, Outcomes and Geographic Variation in Utilization – article – Axelrod DA, Sung RS, Meyer KH, et al. (2010), Am J Transplant, 10(4): 837-845. doi: 10.1111/j.1600-6143.2009.02996.x. Epub 2010 Feb 1.

    Ethics on DCD


    • A Systematic Review of Autoresuscitation after Cardiac Arrest – article – Hornby K, Hornby L, Shemie SD. (2010), Crit Care Med, 38(5): 1246-1253. doi: 10.1097/CCM.0b013e3181d8caaa.
    • Autoresuscitation after Asystole in Patients Being Considered for Organ Donation – article – Sheth KN, Nutter T, Stein DM, et al. (2012), Crit Care Med, 40(1): 158-161. doi: 10.1097/CCM.0b013e31822f0b2a.

    Death Determination

    • Ethical Controversies at End of Life after Traumatic Brain Injury: Defining Death and Organ Donationarticle – Souter M, Van Norman G. (2010), Crit Care Med, 38(9 Suppl): S502-509. doi: 10.1097/CCM.0b013e3181ec5354.
    • How the Distinction between “Irreversible” and “Permanent” Illuminates Circulatory-Respiratory Death Determination – article – Bernat JL. (2010), J Med Philos, 35(3): 242-255. doi: 10.1093/jmp/jhq018. Epub 2010 May 3.
    • International Perspective on the Diagnosis of Deatharticle – Gardiner D, Shemie S, Manara A, Opdam H. (2012), Br J Anaesth, 108 Suppl 1: i14-28. doi: 10.1093/bja/aer397.


    • Donation after Circulatory Death: Burying the Dead Donor Rulearticle – Rodriguez-Arias D, Smith MJ, Lazar NM. (2011), Am J Bioeth, 11(8): 36-43. doi: 10.1080/15265161.2011.583319.
    • Further Deliberating Burying the Dead Donor Rule in Donation After Circulatory Death – article – Chen YY, Ko WJ. (2011), Am J Bioeth, 11(8): 58-59. doi: 10.1080/15265161.2011.591211.
    • Organ Donation after Circulatory Determination of Death: Lessons and Unresolved Controversies – article – Childress JF. (2008), J Law Med Ethics, 36(4): 766-771, 610. doi: 10.1111/j.1748-720X.2008.00336.x.
    • Organ Procurement After Cardiocirculatory Death: A Critical Analysis – article – Rady MY, Verheijde JL, McGregor J. (2008), J Intensive Care Med, 23(5): 303-312. doi: 10.1177/0885066608320928. Epub 2008 Jul 22.
    • The Boundaries of Organ Donation after Circulatory Deatharticle – Bernat JL. (2008), N Engl J Med, 359(7): 669-71. doi: 10.1056/NEJMp0804161.

    OR Flowsheets and Set Up

    • Controversy and Consensus on Pediatric Donation After Cardiac Death: Ethical Issues and Institutional Process – article – Harrison CH, Laussen PC. (2008), Transplant Proc, 40(4): 1044-1047. doi: 10.1016/j.transproceed.2008.03.064.
    • Donation after Cardiac Death in Pediatric Critical Carearticle – Kolovos NS, Webster P, Bratton SL. (2007), Pediatr Crit Care Med, 8(1): 47-49.
    • Building a Successful DCD Program: Planning and Leading Change – article – Chambers-Evans J, Goulet L, Sherry W, et al. (2008), Dynamics, 19(3): 17-21.
    • Donation After Circulatory Death – article – Manara AR, Murphy PG, O’Callaghan G. (2012), Br J Anaesth, 108 (suppl 1): i108-i121. doi: 10.1093/bja/aer357
    • Use of Tissue Plasminogen Activator in Liver Transplantation from Donation After Cardiac Death Donors – article – Hashimoto K, Eghtesad B, Gunasekaran G, et al. (2010), Am J Transplant, 10(2): 2665-2672. doi: 10.1111/j.1600-6143.2010.03337.x

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