BOX 5-5

National Conference on Donation After Cardiac Death (DCD): Specific Actions Proposed for Agencies and Organizations

Association of Organ Procurement Organizations (AOPO)

  • Establish a DCD mentorship in its technical assistance program.

  • Add a DCD component to OPO accreditation standards.

U.S. DHHS Advisory Committee on Organ Transplantation

  • Support studies assessing the frequency of autoresuscitation of patients eligible for DCD and other patients who have died after the withdrawal of life-sustaining therapy.

  • Recommend that the Organ Procurement and Transplantation Network (OPTN) modify data submission standards to capture data from Phase I and Phase II clinical trials with the minute-by-minute collection of data to measure systolic and diastolic blood pressure, the level of oxygen saturation, and urine output.

  • Provide guidance on issues of informed consent.

OPTN-United Network for Organ Sharing (UNOS)

  • Revise transplant center and OPO membership criteria to require DCD protocols.

  • Establish organ-specific subcommittees on DCD to address organ-specific suitability criteria and allocation policies.

affect public perception and damage the understanding and trust of the healthcare system regarding organ donation (Chapter 7).

The committee concurs with the actions recommended in earlier IOM reports (Boxes 5-3 and 5-4) and at the National Conference on Donation after Cardiac Death (Box 5-5) and encourages further efforts to overcome the general inertia regarding the full implementation of the policies and practices that will facilitate and expand DCDD. It will be important to focus on the systems changes at the hospital and the OPO levels and will also require that the public and healthcare professionals be engaged in discussions about the complexities of DCDD.

Learning from Past Experience and International Models

Several European countries have developed and have used the infrastructures of both the emergency medical services and the transplantation services to provide optimal emergency care and to be available as needed to

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