• Joseph R Scalea, Robert R Redfield, Michael D Rizzari, Ryan Bennett, Michael E Anderson, James E Anderson, Dixon B Kaufman, Hans W Sollinger, Luis A Fernandez, Anthony M D'Alessandro, and Joshua Mezrich.
• *Division of Transplantation, Department of Surgery, University of Wisconsin, Madison, WI †University of Wisconsin Organ and Tissue Donation (UWOTD), Madison, WI.
• Ann. Surg. 2016 Feb 1; 263 (2): 211-6.

ObjectiveThe objective of this study was to determine the fate of patients who attempted to donate organs after circulatory death (DCD) using a standardized DCD protocol.BackgroundSuccessful donation is not always possible after attempted DCD.MethodsData were collected for all DCD donors between 1/2011 and 9/2014. DCDs were carried out using a uniform protocol at a single-center organ procurement organization.ResultsDuring the timeframe considered, DCD donation was attempted in 169 patients. In 46 patients (27.2%), no organs were recovered because the patients did not die within 2 hours. Successful donation was more likely if withdrawal of support occurred in the operating room versus the intensive care unit (P = 0.006). Time from extubation to death was available for 161/169 donors (95.3%). Of 161 donors, 111 (66.9%) died in under 1 hour. The mean time from withdrawal of support to patient death for unsuccessful donations was 33 hours, 37 minutes (range, 24 minutes-242 hours) versus 29 minutes (range, 5 minutes-2 hours, 4 minutes) for successful donations. Twenty-seven patients who unsuccessfully donated (67.5%) died within 24 hours. Were unsuccessful donations converted to successful donations, as many as 837 abdominal transplants could have been carried out in the United States, during the study period.ConclusionsDCD is an important form of organ donation. A large number of abdominal transplants are not possible due to unsuccessful DCD organ donation. It may be useful to explore DCD donor family satisfaction to identify other options for improving DCD donation.

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