You are called by your local organ procurement organization and offered a high-quality organ. They tell you “this will be a DCD donor.” What does this mean? What implications does this have post-transplant?
As opposed to neurologically-deceased donors (NDD, i.e. “brain dead” donors), donors after cardiac death (DCD) are declared dead after a period of circulatory arrest (usually 5 minutes). This means that there is an obligatory period of period of warm ischemia before the organs are flushed and cooled. In kidney transplantation, DCD organs are associated with an increased incidence of delayed graft function (DGF – often defined as the need for dialysis in the first week after transplantation). Nevertheless, multiple groups have shown that long-term outcomes are similar whether patients receive kidneys from a standard criteria donor (SCD) who is either NDD or DCD. Results of liver transplantation with DCD organs are also good, although a higher incidence of biliary ischemic strictures has been described. Lung and pancreas transplants are also performed using organs from selected DCD donors.