What follows is a curated distillation of the ANZICS Statement on Death and Organ Donation.
Donation after Circulatory Determination of Death (DCDD)
Maastricht classification – only 3 & 4 used in Aus/NZ
Category | Context | Warm ischaemic time | Degree of control |
Category 1 | Dead on arrival | Unknown | Uncontrolled |
Category 2 | Failed resuscitation (ED or ICU) | Known | Uncontrolled |
Category 3 | Withdrawal of treatment in ICU | Known and limited | Controlled |
Category 4 | Unexpected cardiac arrest following NDD | Known, potentially limited | Uncontrolled* |
Category 5 | Unexpected cardiac arrest in ICU | Known | Uncontrolled |
Stages
Period/timeframe | Commences | Concludes |
Agonal | Withdrawal of Cardiorespiratory Support | Circulatory arrest |
Warm ischaemic time | Varies by organ | Cold perfusion |
Functional warm ischaemic time | SBP <50mmHg | Cold perfusion |
Acceptable ischaemic times in Australia
- Liver & pancreas: Agonal + FWIP <30 minutes
- Heart: <30 minutes from SBP <90mmHg
- Kidneys: FWIP <30 minutes
- Lungs FWIP <90 minutes
or, visually (page 15, Best Practice Guideline for Donation after Circulatory Determination of Death in Australia, DonateLife)
