Organ Donation: Opportunities for Action

Conduct financial analysis of the long-term impact of DCD organ use on transplant centers.
Use regional meetings as a venue for discussion of and education about DCD.

NATCO (The Organization for Transplant Professionals)

Expand DCD in all NATCO education programs.

American Society of Transplant Surgeons and American Society of Transplantation

Establish a joint committee to increase DCD recovery and utilization.

Joint Commission on Accreditation of Healthcare Organizations

Revise accreditation standards to require hospitals to implement DCD protocols.
Provide an annual DCD report that includes regional profiles, new developments, and trends and outcomes.

Centers for Medicare & Medicaid Services

Revise regulations governing donation, utilization, and reimbursement to reflect the unique characteristics of DCD procurement and transplantation.

SOURCE: Bernat et al. (2006).

respond to demands for DCDD (Alvarez et al., 2002; Sanchez-Fructuoso et al., 2003; del Rio Gallegos et al., 2004). Furthermore, in the early 1990s efforts were made in Washington, D.C., to develop a program for uncontrolled DCDD.

Washington, D.C.

In the early 1990s, the Washington Hospital Center in Washington, D.C., developed a rapid organ recovery program that focused on DCDD, particularly organ donation from victims of fatal trauma (Kowalski et al., 1996; Light et al., 1996). The emphasis on DCDD donors (termed “non-heart-beating donors” at the time) included a strong component of community education and input (WHC, 1993). A Community Oversight Committee was formed to provide input into the development of the DCDD protocol (Appendix F) and its implementation. Furthermore, the Office of Decedent

Table of Contents

Front Matter R1-R18

Summary 1-14

1 Introduction 15-44

2 Trends and Patterns 45-76

3 Perspectives and Principles 77-92

4 Systems To Support Organ Donation 93-126

5 Expanding The Population of Potential 127-174

6 Promoting and Facilitating Individual and Family Decisions to Donate 175-204

7 Presumed Consent 205-228

8 Incentives for Deceased Donation 229-262

9 Ethical Considerations In Living Donation 263-280

10 Opportunities for Action 281-282

Appendix A Acronyms 283-284

Appendix B Workshop Meetings 285-288

Appendix C First-Person Consent Status and Organ Donor Registry Participation 289-292

Appendix D Quantifying Self-Interest in Organ Donation 293-298

Appendix E HRSA's Extramural Research Program 299-304

Appendix F Washington Hospital Center: Protocol for the Rapid Organ Recovery Program, Transplantation Services 305-316

Appendix G Committee and Staff Biographies 317-324

Index 325-340

Washington, D.C.