pISSN 2671-8790 eISSN 2671-8804

View

Article View

Korean J Transplant 2021; 35(2): 71-76

Published online June 30, 2021

https://doi.org/10.4285/kjt.21.0004

© The Korean Society for Transplantation

Organ donation after controlled circulatory death (Maastricht classification III) following the withdrawal of life-sustaining treatment in Korea: a suggested guideline

Hoonsung Park1 , Eun-Sil Jung2 , Jae-Sook Oh3 , Yong-Min Lee3 , Jae-Myeong Lee4

1Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
2Transplantation Center, Korea University Anam Hospital, Seoul, Korea
3Korea Organ Donation Agency, Seoul, Korea
4 Division of Acute Care Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea

Correspondence to: Jae-Myeong Lee
Division of Acute Care Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-6622
Fax: +82-2-928-1631
E-mail: ljm3225@hanmail.net

Received: March 16, 2021; Revised: April 7, 2021; Accepted: April 17, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The “Act on hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life” was enacted in February 2018 in Korea. Therefore, we suggest a Korean guideline for organ donation after circulatory death (DCD) category III after the withdrawal of life-sustaining treatment (WLST). Implementation of WLST includes stopping ventilation, extubation, discontinuation of inotropics and vasoconstrictors, cessation of continuous renal replacement therapy, and cessation of extracorporeal membrane oxygenation. Medical staff involved in organ procurement or transplantation surgery cannot participate in the WLST process. Following cardiac arrest, 5 minutes of “no touch time” should pass, after which circulatory death can be declared. The procurement team can enter the room after the declaration of death. The final procurement decision is made after the surgeon visually checks the organ condition. DCD category III activation in Korea will help increase organ donation and reduce the demand-supply mismatch of organ transplantation.

Keywords: Donation after circulatory death, Organ donation, Withdrawal of life-sustaining treatment, Guideline, Korea

HIGHLIGHTS
  • Donation after circulatory death category III activation in Korea will help increase organ donation and reduce the demand-supply mismatch of organ transplantation.