Skip to main content
MedVellum
QuestionsVideosPricing

MedVellum

Fellowship exam preparation across every specialty: source-verified topics, questions in every format, and videos.

Product

  • Specialties
  • Questions
  • Videos
  • Exam tools
  • Pricing

Verification & policy

  • Verified register
  • Editorial policy
  • Privacy
  • Terms

Account

  • Sign in
  • Create account
  • Dashboard
  • Account & billing

© 2026 MedVellum. For education only — not a substitute for clinical judgement.

llms.txtPsychiatry LLM catalogSitemap

ICU TopicsTransplant / organ donation

ICU · Transplant / organ donation

Donation After Circulatory Death (DCD) & Recipient Logistics

Also known as Donation after circulatory death · DCD · Donation after brain death · DBD · Organ donation · Warm ischaemia time · Cold ischaemia time · Normothermic regional perfusion · NRP · Organ retrieval

Donation after circulatory death (DCD) — the organ donation after the confirmed the circulatory the death (the five-minute the observation the period, the no the auto-resuscitation). Distinguished from the donation after the brain death (DBD — the brainstem the death). The DCD the process: the withdrawal of the life-sustaining the therapy (WLST), the five-minute the asystole the confirmation, the warm ischaemia the time (the WIT — the graft-viability the determinant; accepted limits vary by the centre and the organ), the retrieval, the cold the ischaemia (the ice). The normothermic the regional the perfusion (NRP — the improves the utilization and the transplant the outcomes). The recipient the logistics — the matching, the transport (the cold the ischaemia), the transplant.

high17 referencesUpdated 20 Aug 202641 min readVerification in progress

Practise this topic

  • 8 MCQs

Your progress

Saved on this device.

Practise this topic8 MCQs with explanations

Target exams

CICMFFICMEDIC
On this page
Study tools

Your progress

Saved on this device.

Practise this topic8 MCQs with explanations

Target exams

CICMFFICMEDIC

The one-line answer

The one-line exam answer

Donation after circulatory death (DCD) recovers organs after death is declared by permanent cessation of circulation and respiration — a five-minute observation period after circulatory arrest with no pulse, no circulation, and no auto-resuscitation. It is distinguished from donation after brain death (DBD), where organs are perfused right up to the moment of recovery. The entire controlled DCD pathway is choreographed around one clock: the warm ischaemia time (WIT), kept as short as the withdrawal allows, which decides whether the graft is viable — accepted functional WIT limits vary by programme and organ. Normothermic regional perfusion (NRP) — an ECMO-like circuit that re-oxygenates the abdominal organs after death — increases organ utilization and improves transplant outcomes, with a 51% lower risk-adjusted hazard of 12-month liver transplant failure.[2][13][5]

ICU Fellowship (CICM) Pro

Continue reading

You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the ICU Fellowship (CICM) fellowship library.

Sign in to continueSee pricing
References17ShowHide
  1. [1]Kootstra G Statement on non-heart-beating donor programs Transplant Proc, 1995.PMID 7482979
  2. [2]Bernat JL, Capron AM, Bleck TP, et al. The circulatory-respiratory determination of death in organ donation Crit Care Med, 2010.PMID 20124892
  3. [3]Dalle Ave AL, Sulmasy DP The ethical obligation of the dead donor rule Med Health Care Philos, 2020.PMID 31087205
  4. [4]Veatch RM Transplanting hearts after death measured by cardiac criteria: the challenge to the dead donor rule J Med Philos, 2010.PMID 20439354
  5. [5]Oniscu GC, Mehew J, Butler A, et al. Improved Organ Utilization and Better Transplant Outcomes With In Situ Normothermic Regional Perfusion in Controlled Donation After Circulatory Death Transplantation, 2023.PMID 35993664
  6. [6]Eden J, Sousa Da Silva R, Cortes-Cerisuelo M, et al. Utilization of livers donated after circulatory death for transplantation - An international comparison J Hepatol, 2023.PMID 36740047
  7. [7]Summers DM, Watson CJ, Pettigrew GJ, et al. Kidney donation after circulatory death (DCD): state of the art Kidney Int, 2015.PMID 25786101
  8. [8]Summers DM, Pettigrew GJ Uncontrolled DCD donation-tilting at windmills or pushing against an open door? Kidney Int, 2019.PMID 30665566
  9. [9]Antommaria AHM Issues of Fidelity and Trust Are Intrinsic to Uncontrolled Donation After Circulatory Determination of Death and Arise Again With Each New Resuscitation Method Am J Bioeth, 2017.PMID 28430053
  10. [10]Shemie SD, Torrance S, Wilson L, et al. Heart donation and transplantation after circulatory determination of death: expert guidance from a Canadian consensus building process Can J Anaesth, 2021.PMID 33543427
  11. [11]Healey A, Hartwick M, Shemie SD, et al. Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit Can J Anaesth, 2020.PMID 32918249
  12. [12]Greer DM, Shemie SD, Lewis A, et al. Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project JAMA, 2020.PMID 32761206
  13. [13]Zorko DJ, Shemie J, Hornby H, et al. Autoresuscitation after circulatory arrest: an updated systematic review Can J Anaesth, 2023.PMID 37131027
  14. [14]Galeone A, Casartelli Liviero M, Borin A, et al. Early and Mid-Term Results of Solid Organ Transplantation After Circulatory Death: A 4-Year Single Centre Experience Medicina (Kaunas), 2025.PMID 41470127
  15. [15]Allen MB, Billig E, Reese PP, et al. Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death Am J Transplant, 2016.PMID 26361242
  16. [16]Rech TH, Moraes RB, Crispim D, et al. Management of the brain-dead organ donor: a systematic review and meta-analysis Transplantation, 2013.PMID 23545508
  17. [17]Dhar R, Stahlschmidt E, Yan Y, et al. A randomized trial comparing triiodothyronine (T3) with thyroxine (T4) for hemodynamically unstable brain-dead organ donors Clin Transplant, 2019.PMID 30689222

Test yourself

Practise what you just read

  • 8 MCQs
ICU Fellowship (CICM) Pro

$29/ monthor $279 / year

The complete ICU Fellowship (CICM) library, every exam format, one subscription.

  • Complete library for one chosen specialty
  • Timed MCQ mock exams and spaced review
  • Clinical cases & cross-table vivas
See pricingSign in
PreviousSurvival Analysis & the Kaplan-Meier CurveStatistics & evidence-based medicineNextECG & Electrical SafetyEquipment, physics & clinical measurement