Donation after circulatory death – activity review in the Asian region

Abstract

Transplantation remains the optimum treatment for many patients. The availability of donor organs has failed to keep pace with demand, resulting in an ever-increasing waiting list of potential recipients. Using organs from donation after circulatory death (DCD) donors is one of the strategies available to increases the number of donor organs. On one hand in many countries DCD donation has gained popularity and the outcomes are comparable to organ transplantations following brain death donation, but on the other hand still a lot of problems exist for both controlled and uncontrolled DCD regarding ethical and legal issues of DCD program in several regions. There are guidelines though available for the whole process of DCD donation and transplantation from national transplant societies and anaesthesiology societies.

The aim of this paper was to review the DCD activity and the possibilities to improve the number of organ transplantation in the Asian region based on literature search.

A novel donation concept, namely organ donation after brain death followed by circulatory death (DBCD) has been initiated in many Asian countries to help increase the available organs for transplantation since around 2011. The reason why there are so many DBCD donors is because brain death law has not been approved on a national level in most of the Asian countries, and culturally many relatives of deceased donors can only accept donor death when heart beating is irreversibly arrested.

Based on this review there is a need to implement DCD transplant programs and to establish reliable protocols for this type of donation across all the Asian countries to increase the number of transplantations.