Critical issues in donation after circulatory death

There is a major shortage of donor organs for transplantation. Organ donation after circulatory arrest (DCD: donation after circulatory death or cardiac arrest) makes an important contribution to the donor pool. This thesis provides insights into critical aspects of the DCD process and recommendations for optimising the process, from obtaining permission for donation to predicting and confirming the death. The perception of the families regarding the end-of-life care of intensive care patients is positively influenced by a donation procedure. To better utilise the potential for donors in Europe, recommendations are made in this thesis for implementing an ethically acceptable DCD programme. There should be a strict separation between the treatment team of a patient and the team that recommends the donation. The possibility of donation should be discussed as a rule with all dying patients who could be potential donors.