NON-HEART BEATING DONOR

The concept of a “non-heart beating donor” has gained increased attention as a viable alternative to increase the number of qualified organ donors. Because of the advancements in the field of transplantation, many different organs can be recovered from the non-heart beating donors today, including the kidneys, liver, pancreas as well as the lungs and heart in certain cases.

How is this different from donation after brain death?

Organ donation after brain death occurs when the brain has no function but the heart is still beating.

The non-heart beating donor, also known as donation after cardiac death (DCD), is an option for families to proceed with organ donation when there is severe brain injury that is usually irreversible but there is still minimal brain function, which will not meet strict brain-death criteria.

How does the process occur?

The decision to proceed with donation after cardiac death is made after the family has been told by the treating physician that there is no realistic hope of recovery for their loved one. After the family decides to remove life support, only then can the consent for donation after cardiac death be obtained.

To be a viable donor, DCD donors must cease to have a heartbeat within 60 minutes after care is withdrawn. Once death is pronounced by the treating physician, the donor is taken to the operating room where the transplant team procures the organs. If the heartbeat does not stop within 60 minutes, recovery is abandoned as the organs go through a process called “warm ischemia” which makes the organs not usable.

How common is donation after cardiac death?

In 1995, 64 individuals were categorized as DCD donors, compared to 1,494 individuals in 2015, providing 2,876 life saving organ transplants. Overall, approximately 16.5 % total deceased donors were donations after cardiac death, compared to 1.2 % in 1995.