Clinical Implications of Organ Transplantation from Donation after Circulatory Death: A Japanese Multi-institutional Survey

Abstract

【Objective】 To conduct a multi-institutional survey regarding the current attitudes and challenges associated with donation after circulatory death (DCD) in Japan.

【Methods】 The survey was developed by the Committee for DCD of the Japan Society for Transplantation through a series of conference calls. It was distributed via email invitations containing a link to an online questionnaire (Google Forms, CA). Following an initial round of solicitations, reminder emails were sent, and individual follow-ups were conducted to clarify ambiguous responses.

【Results】 Among all respondents, 82% indicated that organ transplantation from DCD donors is necessary, although 34% believed that implementation would be difficult. Approximately 52% of respondents expressed a willingness to perform organ transplantation from DCD donors. The main barriers cited were the absence of established guidelines, insufficient hospital infrastructure, and limited manpower. Notably, 68% reported that they would be willing to proceed with DCD organ transplantation if these issues were addressed.

【Conclusion】 This survey highlights strong support for DCD as a potential solution to the current organ donor shortage in Japan. However, several challenges must be addressed, including ethical considerations and the establishment of standardized guidelines—particularly those related to organ preservation. These findings may serve as a foundation for the development of clinical protocols and institutional systems to facilitate the safe and effective implementation of DCD in Japan.