The number of organ donations after circulatory death (DCD) in the United States surged from 2% of all deceased donors in 2000 to 49% in 2025, according to a study published in JAMA on March 3, 2026. The increase reflects advancements in medical technology and a willingness among organ procurement organizations to recover organs from medically complex donors, potentially expanding access to life-saving transplants.
Researchers, led by Macey L. Levan, JD, PhD, of NYU Grossman School of Medicine, analyzed data from the Organ Procurement and Transplantation Network spanning 25 years. The data revealed a rise in DCD donations across all major organ types: a 49% increase for kidneys, 43% for livers, 24% for lungs and hearts, and 12% for pancreases.
“The transplant community is constantly working on ways to safely expand the types of donated organs that can be used so that more patients can receive the life-saving benefits of transplants,” Levan told Healio. “An increase in donation after circulatory death has expanded access to transplant and helped reduce the organ shortage.”
The study attributes the increase to medical innovations like normothermic regional perfusion and machine-perfusion devices. Normothermic regional perfusion reduces damage to kidneys donated after circulatory death, improving their function post-transplant. Subnormothermic acellular machine perfusion further aids preservation during allocation and transport, according to Levan.
However, the study also highlighted significant regional disparities. Rates of DCD donations varied widely across organ procurement organizations, ranging from 11% to 73% of all donors in 2025. “This variation implies that there are missed opportunities to expand transplant access in some areas,” Levan stated.
The researchers also observed a shift in the characteristics of donors from whom organs were recovered after circulatory death. From 2021 to 2025, a greater proportion of these donors were older, had higher body mass indexes, and were more likely to have pre-existing conditions such as hypertension, diabetes, and hepatitis C. The median Kidney Donor Profile Index for kidneys recovered from these donors worsened, from 48 in 2016-2020 to 64 in 2021-2025.
“Organ procurement organizations are now willing to recover organs from medically complex donors after circulatory death,” Levan explained. “This change is facilitated by technologies that improve outcomes after transplant, but also by increased recognition by transplant centers that earlier transplantation using these organs is better for some patients than waiting a long time for an organ donated after brain death.”
Levan emphasized the need for continued research into organ procurement methods, stating that expanding transplant access will require a combination of technological advancements, removing barriers to living donation, and exploring latest therapies like xenotransplantation.
