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Article ID: CBB270767374

Were the First Transplants Done by Donation after Cardiac Death? (2016)

Frederick J. White (Author)

Social History of Medicine
Volume: 29
Issue: 1
Pages: 131-153

URI: http://shm.oxfordjournals.org.ezproxy.lib.ou.edu/content/29/1/131

DOI: 10.1093/shm/hkv078

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Heart Organ transplantation Organs; tissues Death 20th century, late United States

Controlled organ donation after cardiac death (DCD) after awaiting cardiac arrest (Maastricht Category III) has been controversial since its formalisation in the Pittsburgh Protocol in 1992. Much of the controversy involves its abbreviated time to declaration of death by cardiocirculatory criteria and its departure from brain death in the required determination of death. Proponents assert that DCD is a renaissance of the earliest days of transplantation, before widespread acceptance of the concept of brain death. Equivalence between modern DCD and historic non-heartbeating organ donation is used to justify DCD practice and dismiss concerns that DCD may not meet the required determination of death. However, examination of the thoughts of transplantation pioneers regarding the required determination of death and examination of the facts and circumstances of their early transplantation cases reveals that moral equivalence drawn between modern DCD and the first organ transplants is not well founded in historical evidence.

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