Donation after Cardiac Death (DCD)

There are two ways to become an organ donor. One way is from brain death and the other is to be a donor after cardiac death. Since less than 2% of the population ever meets brain death criteria and many people want the option to donate, Donation after Cardiac Death (DCD) provides individuals and their families another opportunity to donate organs. Additionally, this option increases the number of organs available for the thousands of Ohioans who are currently awaiting life-saving transplants.

Donation after Cardiac Death was the preferred method of organ donation prior to the 1986 Brain Death Act. Shortly thereafter, recovery of organs from patient's who were brain dead became commonplace, since more organs could be recovered for transplantation. Today, both options provide people with the opportunity to give the Gift of Life.

There are times when some ventilator-dependent patients who have irreversible, non-survivable brain injuries never progress to brain death. Other times, a patient's family decides to take the patient off the ventilator before brain death occurs. In these cases, organ donation may still be an option.

LifeBanc has a DCD protocol that has been shared with hospitals throughout Northeast Ohio. It contains the following key points:

  • The potential DCD donor will have sustained an irreversible, non-survivable brain injury due to trauma, stroke, anoxia (lack of oxygen), etc.

  • The discussion of organ donation options will occur only after the family's decision to withdraw ventilator support.

  • The attending physician will pronounce death following irreversible stoppage of the heart and respiratory functions (breathing).
The protocol follows guidelines published by the Institute of Medicine (IOM).

Only after the family has been informed that the patient's condition is terminal and they've made the decision to terminate mechanical support, will a member of the LifeBanc staff approach the family with the option of organ/tissue donation. Prior to speaking to the family, the LifeBanc staff member may consult with the hospital staff regarding their participation in this discussion.

As with all potential organ donors, patient care remains the responsibility of the hospital team.

The physician who declares death is not a member of the transplant/recovery team. Additionally, LifeBanc employees, associated recovery teams and recovery surgeons will not give orders or write orders in the patient's chart prior to the pronouncement of death.

Once the patient is removed from the ventilator, there has been no heartbeat or respiration for at least five minutes and the attending physician declares death, the transplant surgeons complete the surgical recovery of the organs. Because of the amount of time organs are without oxygenation through the DCD protocol, generally, the liver, kidneys and sometimes lungs are recovered for transplantation.