Donation After Cardiac Death (DCD)

This module explains the clinical process, required coordination, and clearly separated roles of the family, hospital care team, and OPO while emphasizing that end-of-life decisions must be made independently of donation.

What You’ll Learn

• The definition of Donation after Circulatory Death (DCD) and how it differs from donation after brain death.

• Which patients may be evaluated as potential DCD donors.

• Why the decision to withdraw life-sustaining treatment must be made independently of any discussion or decision about donation.

• The distinct responsibilities of the hospital care team, attending physician, OPO, and recovery teams.

• How authorization for donation is obtained and documented.

• How the patient’s comfort, dignity, and end-of-life care remain the primary priorities.

• How to coordinate the DCD plan with physicians, nurses, respiratory therapists, operating-room staff, and other involved teams.

• How to explain the DCD process to the family using clear and compassionate language.

• How to prepare the family for the planned withdrawal of life-sustaining treatment.

• How to discuss where withdrawal may occur and whether the family can remain present.

• How comfort medications are managed by the patient’s treating healthcare team.

• How circulatory cessation is identified and death is declared by an authorized healthcare professional who is independent of the organ-recovery team.

• How the required observation period is followed according to applicable law, hospital policy, and OPO protocol.

• Why careful timing and communication are essential after death is declared.

• How organ-recovery teams prepare while maintaining appropriate separation from end-of-life care.

• How to protect the family’s privacy and preserve a calm, respectful environment.

• How to prepare the family for the possibility that death may not occur within the timeframe required for organ recovery.

• How to support the family if donation cannot proceed while ensuring compassionate end-of-life care continues.

• How to document important decisions, communications, clinical events, and required time points.

• How ethical practice, role clarity, and transparent communication protect patient autonomy and family trust.