*Purpose: An IOM report published in 2006 estimated that 22,000 potential uncontrolled Donation after Circulatory Determination of Death (uDCDD) donors die each year in the U.S., representing the largest pool of unused organ donors. Little progress has been made in furthering education and acceptance or developing uDCDD programs across the country despite these findings published over a decade ago.

*Methods: A retrospective review of data for donors recovered between 1995 and 2018 was performed. Overall frequency of uDCDD recoveries performed by OPO was calculated and donor demographics summarized. Utilization, DGF and graft survival outcomes for kidneys recovered from uDCDD donors was evaluated. DGF was defined as the need for at least one dialysis session during the first week after transplantation. Graft survival curves were obtained using the Kaplan-Meier method.

*Results: Over 24 years, 477 uDCDD recoveries were performed in the U.S. Of the 58 active OPOs as of 2018, 13 (22%) had performed no uDCDD recoveries, 29 (50%) had performed 1- 5, 8 (14%) had performed 6-10, and 5 (9%) had performed 11- 15. The remaining 3 OPOs performed 29, 33, and 207 uDCDD recoveries respectively. The mean age of the uDCDD donors recovered was 33 years (r = 6 months to 76 years) with primary cause of death head trauma (n=245, 51%) and they were predominantly male (n=319, 67%). Of the 935 kidneys recovered, 676 were transplanted resulting in a 72% utilization rate. The DGF rate was 50% and graft survival was 85% at 1 year, 76% at 3 years and 68% at 5 years.

*Conclusions: Utilization of kidneys from uDCDD donors is a viable option for addressing the organ shortage in the U.S. Increased education and resources should be applied across the nation to expand uDCDD donation.

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