Introduction: The discrepancy between organ availability and the demands of a growing waiting list has fuelled the need for ways to increase the organ supply. The use of donation after cardiac death (DCD) donors has been promulgated by multiple bodies in order to expand the number of organs available for transplantation. Here, we report the differences in the numbers of organs transplanted per donor for DCD and donation after brain death (DBD) donors, compared by donor age.

Methods: The OPTN/UNOS database was queried as to the number of organs transplanted per donor (OTPD) for DCD and DBD donors, according to donor age (in deciles) between 2000 and 2010.

Results: There were 79,514 donors in this period – of which 73,627 were DBD donors and 5,841 were DCD donors. The mean OTPD was 3.2 in the DBD group compared to 2 in the DCD group.

Sixty-six percent of the DCD donors were between the ages of 11 and 50 years.

Conclusion: DCD donors, the large majority of whom are young donors, yield far fewer organs that are transplanted per donor than age-matched DBD donors, indicating suboptimal use of this donor population. These data highlight the need to energize the discussion regarding the promotion of DCD donors – and perhaps the very foundation of their use as a means of increasing organ availability. We are not fulfilling that mandate.

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