Current international status of organ donation after circulatory death viewed from heart and lung transplantation: Expanding the donor pool by cross-sectional action among transplant organs

Abstract

【Background】 The shortage of organ donors has been critical in Japan both in donation after brain death and conventional donation after cardiac death (DCD). As one of the international trends towards expanding the donor pool, Maastricht Category III controlled DCD (cDCD) has been recognized as a promising strategy.

【Objective】 In order to understand the current status of cDCD organ transplantation, particularly of hearts and lungs, recent world reports are reviewed.

【Results】 In Europe, a significant expansion of the donor pool has been demonstrated by introducing cDCD. Heart as well as lung transplantation from cDCD donors has been developed as a reliable option using ex-vivo machine perfusion in Australia, the UK and other countries.

【Conclusion】 Under the critical shortage of organ donors in Japan, the role of cDCD should be discussed cross-sectionally among transplantation organs taking into consideration ethical and legal issues.