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DCD scenarios were linked to more transplantations in Germany

Two medical professionals wearing surgical caps and masks work together in a dimly lit operating or intensive care environment, with surgical lighting overhead and medical equipment visible in the background.
Pexels • JW MEDICARE PVT LTD · Pexels License
Research area:MedicineTransplantation: Methods and OutcomesOrgan Donation and Transplantation

What the study found

Extending organ donation to cardiac arrest, also called donation after circulatory death (DCD), was associated in the modeled scenarios with more liver and kidney transplantations in Germany. The size of the effect varied by country scenario, and the Austrian scenario did not show an increase.

Why the authors say this matters

The authors conclude that a DCD program could help make more organs available. They also say its effect would depend on accompanying structural measures and societal factors, and that DCD alone would probably not solve organ scarcity.

What the researchers tested

The researchers analyzed trends in organ donation after DCD was introduced in nine European countries and projected those trends onto German donation numbers from 2011 to 2023 using regression analyses. They then modeled the effects on liver and kidney transplantation in Germany with the Eurotransplant simulators ELAS and ETKidney.

What worked and what didn't

Compared with the control scenario without DCD, the largest modeled increase in liver transplantation in 2023 was in the Spain scenario, followed by Switzerland, Belgium, Italy, the United Kingdom, the Netherlands, the Czech Republic, and France. For kidney transplantation, the largest modeled increase was also in the Spain scenario, followed by Switzerland, the Netherlands, the United Kingdom, Italy, Belgium, the Czech Republic, and France. The Austrian scenario showed no increase, with small decreases in both liver and kidney transplantation.

What to keep in mind

These are modeled scenarios based on trends from other European countries, not direct evidence from a DCD program in Germany. The abstract does not describe additional limitations beyond noting that the effect would depend on structural measures and societal factors.

Key points

  • DCD, or donation after circulatory death, was modeled as an extension of organ donation in Germany.
  • The largest modeled increases in both liver and kidney transplantation came from the Spain scenario.
  • The Austrian scenario did not increase liver or kidney transplantation.
  • In most scenarios, waiting lists, MELD scores, and dialysis time at transplantation were reduced as transplant numbers rose.
  • The authors say DCD alone would probably not solve organ scarcity.

Disclosure

Research title:
DCD scenarios were linked to more transplantations in Germany
Publication date:
2026-04-08
DOI:
10.3238/arztebl.m2026.0004
OpenAlex record:
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Image credit:
Pexels • JW MEDICARE PVT LTD · Pexels License
AI provenance: AI provenance information is not available for this post.

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