BD vs DCD: What You Should Know
The Important Differences
Donation following Brain Death (BD) occurs when a patient has complete and irreversible cessation of brain function, usually following trauma or anoxic brain injuries. It is a legal time of death and patients can become organ donors after they are declared brain dead by a physician. Each hospital has a different brain death policy, so make sure you are familiar with yours.
Donation after Circulatory Death (DCD) is the pathway to organ donation for those who do not meet brain death criteria. As families navigate the many difficult, end-of-life decisions for their loved one, organ donation is a critical component of these discussions. A highly trained Lifeline of Ohio family service coordinator will collaborate with the care team to determine an appropriate time frame to share the patient’s registration status or donation information with families of those who are unregistered.
Management and Care
Lifeline of Ohio will lead donor management for patients who meet brain death criteria, including ordering labs and diagnostic tests for the patient. This often includes consultation with the care team, however, Lifeline of Ohio organ recovery coordinators will follow a donor management protocol guided by our medical director that follows strict guidelines according to organ donation regulations and requirements.
In contrast, for patients who will donate organs through the DCD process, management and care of the donor remains under the direction of the hospital care team. Lifeline of Ohio will collaborate with the care team in these instances in order to maximize the gifts of donation.
Prior to DCD recovery, the patient will be transported to a location near an OR where the family can be present during compassionate extubation. The care team will proceed with compassionate extubation following the hospital’s protocol for comfort care.
Organ recovery will occur after patient declaration by a hospital physician and is dependent upon the criteria set by the accepting transplant center. If the patient should not pass in the time frame set by that transplant center, they will be transferred to a location determined by the hospital for continued comfort care provided by the hospital care team. These patients will be honored as heroes in spirit.
Collaboration is Key
Whether the process is DCD or BD, organ donation is a collaborative process that involves many hospital departments including: nursing, neurology, OR, palliative, radiology, respiratory therapy, pharmacy, surgery, chaplaincy, leadership and many others.
Without our amazing hospital partners, Lifeline of Ohio would not be able to help save lives, so thank you for supporting and learning more about organ donation.
Thank you to Lifeline of Ohio Organ Recovery Coordinator Tyler Iffland for contributing to this story.