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​WHAT IS DONATION AFTER CIRCULATORY DEATH (DCD)? 

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​What does circulatory death mean?
Circulatory death occurs when the heart stops beating.

What does donation after circulatory death (DCD) mean?
Donation after circulatory death means that after the heart has stopped beating and death is pronounced by a physician, organs and tissues may be recovered and offered for transplant.

Who can be a DCD donor?
A patient who has a severe neurological injury such as a stroke, bleeding into the brain, trauma or suffocation may be a DCD donor. Patients who have amyotrophic lateral sclerosis, or ALS, as well as patients with spinal cord injuries may also be DCD donors. With these kinds of serious injuries, the brain is too damaged to recover but continues to have minimal function. However, the patient will not survive without ventilator support.

What is ventilator support?
A ventilator is a machine that “breathes” for a patient when the patient is not able to breathe on his or her own. Ventilators, sometimes called respirators, provide oxygen to the lungs through a tube that is placed in the patient’s
throat. When the brain is too damaged to recover, it cannot instruct the lungs to keep breathing or the heart to keep beating. In order to sustain life, the patient needs ventilator support. Ventilators are common in hospitals.

What is the situation that leads up to a DCD donation?
Once the hospital medical team has determined that the patient will not survive or have any meaningful improvement, even with ongoing care and ventilator support, a family may elect to discontinue or forgo further medical intervention. This careful decision includes withdrawal of support, or removing the ventilator, allowing death to occur naturally.

What happens once the family decides to withdraw ventilator support?
After the family makes the decision to stop ventilator support, they will be guided through some end-of-life decisions, including decisions about organ and tissue donation. LifeShare, which is responsible for helping with organ donation and transplantation will be notified. A LifeShare Coordinator will examine the patient and work with the hospital staff to determine if the patient is suitable to be a donor. If the patient can be a donor, the LifeShare Coordinator will speak with the family about organ and tissue donation.

What happens before the ventilator is discontinued?
Until the time of death, the patient remains under the care of the hospital physician and medical team. All comfort measures are maintained, and care is never compromised. The patient will continue to receive pain medication and
other treatments, as directed by the attending physician. If the family chooses, they may be able to remain present and follow rituals that are important for end of life, such as prayers, music or inviting those close to the patient to be present.

What happens next?
Once the ventilator support has been removed and the heart stops beating, a physician from the hospital will declare death. After the declaration of death by the patient’s physician, a five-minute period is observed, and death is confirmed.
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At this point, the patient will be prepared for surgery. A separate team of physicians and professionals will perform the organ recovery. After the surgical procedure, the organs will be provided for transplant.

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