Living vs. Deceased Donors

Deceased organ donation

Deceased organ donation for transplantation comprises donation after brain death (DBD) and donation after circulatory death (DCD) (Dominguez-Gil et al., 2011). Donation after brain death was established based on the Harvard definition of brain death in the 1970s (Report of the Ad Hoc Committee of the Harvard Medical School, 1968). Over the past several years the number of available DBD transplantations has decreased leading to an expansion in the use of controlled and uncontrolled DCD donors.

Donation after circulatory death is now practised worldwide having been endorsed by the World Health Organization (WHO). Schemes to increase DCD use have been adopted by many countries to address the imbalance between organ supply and demand, and are used in kidney, liver, pancreas, and lung transplantation. These organs in particular, have a lower tolerance of warm ischaemia (Dominguez-Gil et al., 2011; Manara et al., 2012; Morrissey and Monaco, 2014).

Critical pathways for organ donation from a deceased donor are shown in the figure below (Dominguez-Gil et al., 2011).

Critical pathways for organ donation from a deceased donor (Domınguez-Gil et al., 2011).

Figure 4: Critical pathways for organ donation from a deceased donor (Domınguez-Gil et al., 2011).

Living organ donation

Living organ donation is now a common practice for both kidney (Davis and Delmonico, 2005) and liver transplantation (Bhangui et al., 2011; Grant et al., 2013). Living lung donor transplantation is also an option for some patients with end-stage lung disease (National Institute for Health and Care Excellence [NICE, IPG170], May 2006).