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The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. Strengthen and Integrate Organ Donation and Quality End-of-Life Care Practices. Hospitals, OPOs, and other healthcare entities should consider how best to integrate the organ donation process with quality end-of-life care practices. Interdisciplinary teams should align end-of-life protocols, practices, and guidelines with organ donation protocols. Enhance Training for Healthcare Professionals. HRSA, in collaboration with palliative care and other professional associations representing diverse disciplines and specialties (including, but not limited to, critical care professionals, transplantation professionals, social workers, and clergy), should strengthen training in end-of-life practices and organ donation, including processes of communication and decision making, with the goal of establishing a knowledgeable and positive environment that supports organ donation. EXPANDING THE POPULATION OF POTENTIAL DONORSMost transplantable organs come from deceased donors who have been declared dead by neurologic criteria. Because many more deaths in the United States are determined by circulatory criteria than by neurologic criteria, there is great potential to expand the number of potential organ donations. The committee acknowledges that donation after circulatory determination of death (DCDD) can be a more complex and less facile process than donation after neurologic determination of death. However, expanding the nation’s capabilities, particularly in large urban areas with excellent emergency medical care, could provide the opportunity for donation to larger numbers of individuals and families. One set of conservative estimates suggests that at least 22,000 of out-of-hospital cardiac arrest deaths annually in the United States could be potential donors if important ethical and practical matters could be resolved. Before proceeding further, demonstration projects to assess the feasibility of undertaking such a strategy within a defined community should be considered. Recommendations: Implement Initiatives to Increase Rates of Donation after Circulatory Determination of Death. HRSA, the National Institutes of Health (NIH), OPTN, OPOs, donor hospitals, transplant centers, and professional societies
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