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A multidisciplinary Indian joint position paper reviews donation after circulatory determination of death and its potential role in expanding the country's deceased-donor pool. The paper addresses ethical, medical, legal, economic and logistical considerations specific to the Indian setting. It outlines controlled donation after circulatory death, including separation of withdrawal-of-life-sustaining-treatment decisions from subsequent donation decisions. It also discusses consent, the no-touch period, the possibility of stand-down without donation and approaches to organ-specific preservation. The paper is especially relevant because CritiCARE 2026 includes dedicated sessions on brain-stem death, donation after circulatory death, donor care and end-of-life decision-making in India. For HCPs, the key lesson is that successful DCD programmes require more than surgical capability. Clear governance, trained multidisciplinary teams, transparent family communication and robust documentation are essential to protect patient dignity and public trust. The paper also highlights the emerging role of regional perfusion and ex vivo machine perfusion in improving organ utilisation. This is a practical evidence base for clinicians involved in donor pathways and provides a distinctly Indian perspective within a global transplant framework.
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A multidisciplinary Indian joint position paper reviews donation after circulatory determination of death and its potential role in expanding the country's deceased-donor pool. The paper addresses ethical, medical, legal, economic and logistical considerations specific to the Indian setting. It outlines controlled donation after circulatory death, including separation of withdrawal-of-life-sustaining-treatment decisions from subsequent donation decisions. It also discusses consent, the no-touch period, the possibility of stand-down without donation and approaches to organ-specific preservation. The paper is especially relevant because CritiCARE 2026 includes dedicated sessions on brain-stem death, donation after circulatory death, donor care and end-of-life decision-making in India. For HCPs, the key lesson is that successful DCD programmes require more than surgical capability. Clear governance, trained multidisciplinary teams, transparent family communication and robust documentation are essential to protect patient dignity and public trust. The paper also highlights the emerging role of regional perfusion and ex vivo machine perfusion in improving organ utilisation. This is a practical evidence base for clinicians involved in donor pathways and provides a distinctly Indian perspective within a global transplant framework.
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