Introduction: Organ Donation and Death from Unexpected Circulatory Arrest: Engaging the Recommendations of the Institute of Medicine

Abstract

This symposium explores the boldest recommendation of the Institute of Medicine’s (IOM) Committee on Increasing Rates of Organ Donation (hereafter Committee), namely, the recommendation that the U.S. consider a new population of potential donors. In its 2006 report, Organ Donation: Opportunities for Action, the committee recommended pilot programs in socalled “uncontrolled” donation after a circulatory determination of death (uDCD). Potential uDCD donors have died from an unexpected loss of circulation, either due to sudden cardiac arrest or excessive blood loss following traumatic injury. Because circulation is lost before death is determined and long before organ procurement could begin, potentially transplantable organs will die from oxygen starvation (warm ischemia) unless they are quickly preserved by cooling or other means.