Donation after circulatory death, or DCD, accounted for 49.2% of organ donations in the United States last year, up from about 2% in the early 2000s, after decades of building out the system through measures such as the 1984 National Organ Transplant Act (NOTA).
The share of DCD among all donors rose from the 2% range in the early 2000s to 18.3% in 2017, 25.6% in 2020 and 32.1% in 2022 before reaching 49.2%, or 8,129 donors, last year, according to the Health Resources and Services Administration (HRSA) under the U.S. Department of Health and Human Services on the 28th. DCD refers to the recovery of organs for donation at the point when death is finally confirmed after cardiac or circulatory arrest, rather than after a determination of brain death.
The rising share of DCD stems from solid infrastructure. With the 1984 National Organ Transplant Act, the United States established the basis for federal support of organ procurement organizations (OPOs) and built a nationwide system for procuring and allocating organs. Linking OPOs to public health insurance programs such as Medicare and Medicaid in 1986 proved especially effective. National infrastructure that closely connects hospitals with specialized procurement organizations has served as the foundation for the spread of DCD. In Korea, by contrast, the absence of a legal basis means DCD donation is effectively not taking place. "To save the lives of patients waiting for organ transplants, the software and infrastructure must be built, including a legal basis for introducing DCD," said Lee Sam-yeol, president of the Korea Organ Donation Agency.
