Table 2.
Summary of the characteristics of donation after brainstem death and donation after circulatory death
Donation after brainstem death | Donation after circulatory death | |
---|---|---|
Donation cohort | Patients that fulfil the criteria for brainstem death but maintain cardiac output | Donors who have died or are awaiting cardiac death |
Proportion of donors | ≈ 65% | ≈ 35% |
Warm ischaemic time | Minimal, due to maintenance of cardiac output | Usually prolonged, due to the interval after asystole where organs are not perfused and have not yet been cooled |
Pathophysiological insult | Brainstem death results in systemic cytokine and cathecholamine release associated with haemodynamic instability and graft insult | Prolonged warm ischaemia stimulates the activation of innate and adaptive immune responses, generation of reactive oxygen species and induction of apoptosis |
Graft outcomes | Current data suggest that careful selection of DCD candidates confers a long-term graft outcome that is comparable to DBD donors [60, 112] |