Organ donation involves the donation of healthy organs and tissues from one person for transplantation into another. It
is now being increasingly accepted that
organ and tissue donation should be
considered a routine part of end-of-life care in both
intensive care unit and emergency department. Expert opinion is that a
single donor can
save as many as 50 people. Demand for organs
for transplantation outstrips supply in almost every country of
the world. Wait for an organ can often be measured in years in many places.
Donation after
circulatory death (DCD) is a transplantation policy widely
practiced worldwide; it has been endorsed by the World Health
Organization
. Most of the times, organs and tissues to be transplanted are obtained
from dead donors, i.e. those declared
brain dead. DCD
involves retrieval of organs for the purposes of transplantation that follows
death confirmed using circulatory criteria. Though
originally introduced for
kidney retrieval,
shortfall in the availability of organs for transplantation has prompted many
countries to extend DCD to organs such as the
liver, pancreas,
and
lungs.
Candidates for DCD are individuals who are on ventilator support due to nonrecoverable or
irreversible neurologic injury not meeting brain death criteria. Much studies
have been done to compare the functionality and survival of DCD organs
especially kidneys with ones retrieved from brain dead donors. Values have been
found to be comparable. However DCD kidneys were associated with technical
complications such as higher rates of primary
graft nonfunction, delayed graft function, discard, and retrieval associated
injury. These, however, do not affect the long-term organ function and
survival.
With adequate precautions, such
as maintenance of normothermic (i.e. normal
temperature) regional perfusion during DCD abdominal organ retrieval, organ injuries due to poor blood supply (ischemic
organ injury) can be averted. Extension
of the concept of living kidney donation in relation to imminent death of
potential DCD donors can help us to achieve a significant increase in
transplantable kidneys.
Ongoing researches are trying
to identify, prevent, and repair DCD-associated organ retrieval
injury. Encouraging results have been obtained using techniques such as ex situ
pretransplant organ perfusion of DCD organs.
Download
an Organ Donor Card From http://www.mohanfoundation.org/downloads.asp
References:
1. Donation After Circulatory Death: Current
Practices, Ongoing Challenges, and
Potential Improvements: Morrissey, Paul E.; Monaco, Anthony P. ( Lippincott Williams & Wilkins,
2013)
2.
Donation after circulatory death.Manara AR, Murphy PG, O'Callaghan
G. Br J Anaesth. 2012 Jan;108 Suppl 1:i108-21. doi: 10.1093/bja/aer357.
Source-Medindia
Careers
