Emory Transplant Center Offers New Technique to Improve Lung Transplant Access

According to the Organ Procurement and Transplantation Network of the U.S. Department of Health and Human Services, more than 1,000 people in the U.S. are on the waiting list for a lung transplant.

With the need for lung donation far outpacing the availability of donor organs, many people with end-stage lung disease will wait months or even years for a life-saving lung transplant.

Experts at Emory Transplant Center are committed to extending the lives of patients awaiting transplant while also advancing techniques to increase the number of available donor organs.

Emory’s Lung Transplant Program now offers organ donation after cardiac death (DCD), an innovative approach to improving lung transplant access for patients in need.

“DCD not only expands the number of available organs for transplantation, it also offers grieving families a way to find meaning in the tragic loss of a loved one,” says David Neujahr, MD, medical director of the Emory Lung Transplant Program at Emory Transplant Center. 

Though organ donation can occur after either cardiac death or brain death, most organs transplanted in the U.S. come from donors who have been declared brain dead.

Cardiac death — also called irreversible cardiac arrest — is different from brain death. Brain death is declared when the brain stops working before the heart stops. Cardiac death occurs when the heart stops working first.

In the case of organ donation, cardiac death occurs after the removal of mechanical support following a brain injury. In this case, and in close consultation with family, a patient who doctors have determined will not recover is removed from a ventilator and progresses naturally to cardiac arrest. It is this type of cardiac death that is considered for the DCD process.

The DCD Process

DCD is an option presented to families only after they have decided to discontinue mechanical support for their loved one.

Families considering DCD will meet with their care team and with coordinators from a local organ procurement organization (OPO). OPO coordinators ensure that families fully understand the DCD process and all options involved.

With agreement to move forward with DCD, a patient is taken to the operating room where mechanical and medical support is removed. Once cardiac death is declared, a mandatory wait time begins before the surgical team can enter the room and begin to procure organs from the donor.

“Developing a framework for DCD requires significant care coordination between a hospital’s critical care team and local OPO,” says Dr. Neujahr. “By working together, we can ensure adherence to strict policies guiding the organ donation and transplantation process.”

What DCD Means for People Awaiting Lung Transplant

DCD offers the potential for increasing the number of organs available to patients in need.

“With only a few centers nationally that offer DCD lung transplant, we don’t anticipate that this technique will solve national organ shortages,” says Dr. Neujahr. “But offering this option here at Emory is a critical step toward improving transplant access in our community. 

Emory Transplant Center offers the only Lung Transplant Program in Georgia. Our program specializes in the treatment of complex lung disorders and offers the full continuum of high-level care involved in lung transplantation. Performing more than 500 lung transplants, we are at the forefront of clinical excellence, innovative transplant therapies, and outstanding pre- and post-transplant care.