AB218. 78. My heart will go on: a case report on organ donation after circulatory death

Abstract: We present a case of organ donation after circulatory death (DCD) involving a 54-year-old male. This case exemplifies the clinical pathways and decision-making processes that can lead to successful and ethically sound DCD. We aim to shine some light on DCD, an under-utilised and valuable source of organs for the transplant pool in Ireland. DCD is a rare but growing entity in Ireland. Since inception in Beaumont hospital in 2011, DCD has expanded to include other Dublin hospitals. To date there has been 42 kidney and 2 lung transplants via DCD. Long term outcomes of DCD in Ireland are comparable to donation after brain stem death. Following an episode of collapse, the patient was brought in by ambulance to Beaumont hospital intubated and ventilated. Brain imaging showed extensive haemorrhage and hypoxic ischaemic injury. A severely encephalopathic state was confirmed on electroencephalography. From this point, there was a redirection of therapy towards end of life care. A clear and ethical progression through the DCD decision making algorithm was carried out, resulting in successful organ retrieval and donation. DCD offers a viable and useful alternative when conditions of brain stem death cannot be satisfied. DCD has not yet realised its full potential in Ireland. Along with education and careful planning, the DCD clinical guidelines published by the Intensive Care Society of Ireland in 2016 will help facilitate the expansion of DCD nationwide.

Keywords: Organ; donation