Klasyfikacja dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia

SummaryIn the early days of transplantation most organs were procured from donors after circulatory death. Later on, as a result of a wide acceptance of the concept and diagnosis criteria of brain death, donation from donors after brain death replaced donation after circulatory death, which finally became the standard (except for several countries). Renewed interest in donation after circulatory death started in the 1990s, resulting from the persistent organ shortage from donation after brain death and the need to bridge the gap between the need for transplantation and the number of available organs. Presently, in many countries donation after circulatory death accounts for even up to 30-40% of organ procurement activity. However, the lack of unified guidelines on donation after circulatory death has challenged the medical, ethical, legal and transplant community on several grounds. Issues concern problems like end-of-life palliative treatment and its withdrawal phase, or the definition of circulatory death and its irreversibility. Both legislation on and the practice of donation after circulatory death differ significantly in different countries. In parallel with the development of this type of donation, new terms, criteria and recommendations have arisen, resulting in constantly changing and unceasingly emerging terms and definitions used in the literature, at scientific conferences and symposiums, or between countries and institutions. A need has emerged for a consensus and clear guidelines to deal with the ethical, legal, organizational, and technical challenges. Te compilation of a classification of donors after circulatory death has been envisaged to serve this purpose. This paper presents and discusses different classifications of donors and donation after circulatory death.