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DCD

Educational Guide

A Comprehensive Resource for OPOs & Hospital Patient Care Teams for Building and Supporting Effective Practices Surrounding Organ Donation After Circulatory Death

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Executive Summary

Hospital Leadership Framework for DCD Implementation

Staggering Growth: 2024 saw the highest number of Donation after Circulatory Death (DCD) donors ever

As DCD becomes a more common pathway for organ donation, it is critical that healthcare organizations and OPOs collaborate to build a highly dependable, standardized, cohesive DCD process to foster a successful and sustainable DCD program, as well as to stay apprised with the updates and directives being issued by the Organ Procurement and Transplantation Network (OPTN).

Strategic Importance of DCD:

  • Expands donor pool to meet the growing demand for transplantable organs.
  • Improves hospital performance metrics related to donation rates and national benchmarks.
  • Demonstrates commitment to patient-centered care and the respectful honoring of end-of-life decisions and designations.

Recommendations from the Academies of Science, Engineering, and Medicine (NASEM) (2022):

  • Eliminate variation in DCD practices across hospitals, OPOs, and transplant centers.
  • Set bold goals using top-performing institutions as benchmarks.
  • Aim for DCD donors to make up at least 45% of all donors.

Organ Procurement and Transplantation Network (OPTN)’s Position (2025):

  • Based on medical evidence, the recommended waiting time that best balances the risks for ischemic injury to organs with the risk of autoresuscitation is 5 minutes.
  • Any OPO and hospital that utilizes a shorter waiting time are urged to reassess standard operating procedures that reflect a shorter wait time.
  • At any time, if uncertainty arises (e.g., signs of organ perfusion, spontaneous respiration, cardiac motion, etc.), the process should be paused and the situation reassessed. An incision should not occur until it is certain that cardiac activity has ceased.

DCD Educational Guide: A National Resource

The Organ Donation and Transplantation Alliance has published the first comprehensive, national DCD Educational Guide to do just that.

Core Framework: 11 Essentials for Effective DCD Practice

Each essential features:

  • Fact-Finding Questions – to assess current practices.
  • Key Points – for implementation and improvement.
  • Model Elements – to illustrate best practices.
  • Tools & Resources – embedded for practical use.

Through the strategic application of these Essentials, healthcare leaders can explore innovative solutions for addressing challenges within their DCD programs. By leveraging data-driven insights and fostering multidisciplinary teamwork, organizations can create a culture of accountability and excellence. This approach not only enhances operational efficiency but also honors the profound impact of donation on patients, families, and communities.

Bottom Line

Support of DCD protocols leads to increased donation opportunities, stronger team coordination, enhanced hospital reputation, and improved regulatory alignment.

Call to Action for Healthcare Leaders:

  • Partner with local OPOs to evaluate and enhance DCD processes.
  • Use the 11 Essentials to identify gaps and standardize practices.
  • Foster a culture of accountability, innovation, and compassion.