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Title: Organ donation after circulatory death in a university teaching hospital
Austin Authors: Sidiropoulos, Sofia ;Treasure, E;Silvester, William;Opdam, Helen I ;Warrillow, Stephen J ;Jones, Daryl A 
Affiliation: DonateLife Victoria, Victoria
Austin Health, Heidelberg, Victoria, Australia
University of Melbourne, Victoria, Australia
University of Sydney, NSW, Australia
Warringal Private Hospital, Heidelberg, Victoria, Australia
Organ and Tissue Authority, Canberra, ACT, Australia
Epworth Eastern Private Hospital, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Issue Date: Jul-2016 2016-07
Publication information: Anaesthesia and Intensive Care 2016; 44(4): 477-483
Abstract: Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3–11] versus 2 [2–3] days; P <0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.
ORCID: 0000-0002-7240-4106
PubMed URL:
Type: Journal Article
Subjects: Donation after cardiac death
Donation after circulatory death
Organ donation
Appears in Collections:Journal articles

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