Does comfort therapy during controlled donation after circulatory death shorten the life of potential donors?

• Published in: Clinical transplantation Vol. 28; no. 1; pp. 47 - 51
• Main Authors: Ledoux, Didier, Delbouille, Marie-Hélène, Deroover, Arnaud, Lambermont, Bernard, Meurisse, Michel, Damas, Pierre, Joris, Jean, Detry, Olivier
• Format: Journal Article Web Resource
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-01-2014; Blackwell
• Subjects: Aged; Anesthesia & intensive care; Anesthésie & soins intensifs; Brain Death; Chirurgie; end-of-life; ethics; Female; Follow-Up Studies; Human health sciences; Humans; Longevity; Male; Middle Aged; non-heart beating donors; organ donation; organ transplantation; Organ Transplantation - mortality; Organ Transplantation - statistics & numerical data; policy; Prognosis; Prospective Studies; Retrospective Studies; Sciences de la santé humaine; Surgery; Time Factors; Tissue and Organ Harvesting - ethics; Tissue and Organ Harvesting - statistics & numerical data; Tissue and Organ Procurement - ethics; transplantation; Withholding Treatment; end-of-life; ethics; organ donation; transplantation; non-heart beating donors; policy
• ISSN: 0902-0063; 1399-0012; 1399-0012
• DOI: 10.1111/ctr.12276

Introduction
Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life.
Methods
The authors retrospectively analyzed prospectively collected data on patients proposed for DCD at the University Hospital of Liege, Belgium, over a 56‐month period. The survival duration of these patients, defined as duration between the time of proposal for DCD and the time of circulatory arrest, was compared between patients who actually donated organs and those who did not.
Results
About 128 patients were considered for controlled DCD and 54 (43%) became donors. Among the 74 non‐donor patients, 34 (46%) objected to organ donation, 38 patients (51%) were denied by the transplant team for various medical reasons, and two potential DCD donors did not undergo procurement due to logistical and organizational reasons. The survival durations were similar in the DCD donor and non‐donor groups. No non‐donor patient survived.
Conclusions
Survival of DCD donors is not shortened when compared with non‐donor patients. These data support the ethical and respectful approach to potential DCD donors in the authors' center, including regular comfort therapy.