DCD Pause Process
Patient Safety Comes First
Nevada Donor Network is committed to maintaining the highest standards of patient care throughout the donation process. Under national Organ Procurement and Transplantation Network (OPTN) requirements, an unplanned Donation After Circulatory Death (DCD) pause may be requested if concerns arise regarding a patient's safety, clinical eligibility, or care during the donation process. When a pause is initiated, donation-related activities are temporarily suspended while concerns are reviewed and addressed. This safeguard promotes transparency, supports informed decision-making, and reinforces our commitment to patients, families, and healthcare partners.
A DCD pause may be requested when additional review is needed regarding a patient's candidacy, including questions related to neurological assessments, changes in clinical status, or to ensure the Organ Procurement Organization (OPO), donor family, and donor hospital share a common understanding of the patient's condition and the planned path forward. The purpose of the pause process is to support patient safety, communication, and alignment among all parties involved. It is not intended to question an individual's decision to be a donor or a family's authorization for donation.
Important Information About the DCD Pause Process
A DCD pause is a patient safety and communication safeguard designed to ensure clinical concerns are appropriately reviewed and resolved. A pause may be initiated to further evaluate a patient's clinical suitability for donation, address questions related to neurological assessments, or ensure alignment among the Organ Procurement Organization (OPO), donor hospital, and donor family regarding the planned course of care and donation process. A pause does not revoke, invalidate, or question an individual's First-Person Authorization, donor registration status, or legally authorized donation authorization. Rather, it provides a structured process for ensuring patient safety, clear communication, and the highest standards of care throughout the donation process.
Key Definitions
Click on the '+' icon to the right of each term to view the definition.
A pathway for organ donation that may occur after a patient, family, and healthcare team have made the independent decision to withdraw life-sustaining therapies (WDLST) and transition to comfort-focused care. Following withdrawal of life-sustaining therapies, death is declared based on the irreversible cessation of circulatory and respiratory function. Donation may then proceed in accordance with the patient's First-Person Authorization (FPA), as documented through state donor registries and other legally recognized authorization sources, or, when no prior authorization exists, through the patient's legal next of kin in accordance with the Uniform Anatomical Gift Act (UAGA) and applicable state law. Donation proceeds only when clinical criteria for donation suitability are met, as determined by the Organ Procurement Organization (OPO) in collaboration with the patient's healthcare team.
A legally binding decision made by an individual during their lifetime to be an organ, eye, and tissue donor. This authorization may be documented through state donor registries, driver's license designation, or other legally recognized donor registration sources. Under the UAGA, an individual's documented donor designation is honored and does not require additional authorization from another party.
The legal framework adopted in all U.S. states that governs organ, eye, and tissue donation. The UAGA establishes how donation decisions are made and identifies who may authorize donation when an individual has not previously documented their own decision. When no First-Person Authorization exists, donation authorization may be provided by a legally authorized representative following the authorization hierarchy established by applicable state law.
A federal agency within the U.S. Department of Health and Human Services that provides oversight of the nation's organ donation and transplantation system. HRSA directed the development of enhanced patient safety requirements related to the DCD process.
The national network responsible for developing and implementing policies that govern organ donation and transplantation in the United States. OPTN approved the DCD policy changes effective November 18, 2026.
References
- HRSA Directive for OPTN Donation after Circulatory Death Policy Development (HRSA Resource)
- Nevada Revised Statutes 451.556 - Persons Authorized to Make Anatomical Gift (Nevada Anatomical Gift Law)