Donation After Cardiac Death (DCD) Overview for Organ Donation
Over 115,000 people nationwide are awaiting a life-saving organ transplant. One organ donor can save up to 8 lives and one tissue donor can restore health for 50-75 people. The majority of organ donors are individuals who are pronounced dead by neurologic criteria. However, less than 1% of all deaths are brain deaths and therefore opportunities for donation are severely limited. Donation after Cardiac Death, formerly called Non-Heart Beating Donation, may be an option for families of patients with a non- survivable injury but who may not meet criteria for brain death. Once the decision has been made to discontinue ventilator support, NJ Sharing Network may offer the opportunity for donation. DCD has been an end-of-life option for patients and families for more than 30 years. Prior to the introduction of brain death laws in the 1960s, DCD was the way in which all organs were recovered.
NJ Sharing Network is notified on any vented patient, regardless of age or diagnosis, with a GCS of 5 or less, documented loss of 2 or more cranial nerve reflexes or family discussions for withdrawal of ventilator support.
Donation after Cardiac Death (DCD) Process:
Over 115,000 people nationwide are awaiting a life-saving organ transplant. One organ donor can save up to 8 lives and one tissue donor can restore health for 50-75 people. The majority of organ donors are individuals who are pronounced dead by neurologic criteria. However, less than 1% of all deaths are brain deaths and therefore opportunities for donation are severely limited. Donation after Cardiac Death, formerly called Non-Heart Beating Donation, may be an option for families of patients with a non- survivable injury but who may not meet criteria for brain death. Once the decision has been made to discontinue ventilator support, NJ Sharing Network may offer the opportunity for donation. DCD has been an end-of-life option for patients and families for more than 30 years. Prior to the introduction of brain death laws in the 1960s, DCD was the way in which all organs were recovered.
NJ Sharing Network is notified on any vented patient, regardless of age or diagnosis, with a GCS of 5 or less, documented loss of 2 or more cranial nerve reflexes or family discussions for withdrawal of ventilator support.
Donation after Cardiac Death (DCD) Process:
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NJ Sharing Network is notified of potential end-of-life decision to withdraw ventilator
support.
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NJ Sharing Network evaluates for medical suitability and uses an evaluation tool with
respiratory therapy to measure the patient’s respiratory drive and determine the likelihood
patient will progress to cardiac death immediately after extubation (within 90 minute
timeframe).
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NJ Sharing Network will offer donation options to family. If consented, patient is extubated in
operating room or holding area (comfort care measures as prescribed by hospital physician –
medications provided by patient’s nurse).
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Once a patient progresses to cardiac death, they are pronounced dead by a licensed hospital
physician who is present during the withdrawal.
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Transplant physician (who is on-site at the hospital and prepared for organ recovery) enters
operating room to recover kidneys, liver and possibly pancreas.
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There is a 90 minute time frame in which organs can be recovered after extubation to
pronouncement of death. If the patient does not progress to cardiac death within this time,
organ donation cannot occur. Tissue donation may still be an option after death.
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DCD provides more families the opportunity to donate resulting in more patients receiving
life-saving transplants.
