Single-centre experience of donation after cardiac death

Objectives: To describe the design, development and implementation of an organ and tissue donation after cardiac death (DCD) program, evaluate its success and assess its impact on tissue and organ availability and the number of donors after brain death. Design, participants and setting: Prospective collection of patient characteristics and outcomes for actual and potential donors from 2000 to 2010, thus including the 5 years after the implementation of a DCD program at a major Australian tertiary hospital in 2006. Main outcome measures: The number and type of donors before and after implementation of the DCD program, and subsequent numbers of solid organ and tissue donations. Results: The DCD program was associated with an increase in overall donor numbers. There were 80 donors (20 DCD and 60 donation after brain death [DBrD]) after 2006, compared with 51 DBrD donors in the previous 5 years. Four of the DBrD donors were patients who were initially considered for DCD. DCD accounted for eight of the total 19 donors in 2009 and seven of the total 23 donors in 2010. There were 62 solid organ and 35 tissue and cornea transplants as a result of the DCD program. Conclusions: Successful implementation of a DCD program is possible and has led to an increase in overall donor numbers and organs transplanted without any reduction in DBrD donors. The widespread implementation of DCD across Australia may help reduce the shortfall of organs for transplantation.