Overview
- An NYU-led analysis reports donation after circulatory death rose from 2% of deceased donors in 2000 to 49% in 2025, as more than 100,000 people await transplants and just over 49,000 were performed last year.
- Organs recovered after the heart stops now supply many kidneys and livers, with growing use for lungs, hearts, and pancreases, aided by normothermic regional perfusion and ex vivo machine perfusion.
- Adoption varies widely across the 55 OPO regions, with DCD comprising 11% to 73% of donors, a gap linked to hospital resources and uptake of newer perfusion technologies, according to AOPO.
- HRSA proposals would add safeguards such as the ability to pause preparations if suitability is questioned, require OPOs to document appropriate neurological exams, and ensure families receive clear education; many OPOs are deploying checklists, and ICU withdrawal is encouraged to reduce confusion.
- Rules separate end-of-life decisions from transplant teams, require a roughly five-minute observation after cardiac arrest before declaring death, and forgo recovery if death is not timely; today’s DCD donors are older, have higher BMI, and more comorbidities than in earlier years.