To explore the measures and effect of donor assessment and maintenance of organ function in donation after cardiac death (DCD).

Clinical data of 47 DCD donors from January 2015 to June 2019 in the People's Hospital of Wengyuan County, Shaoguan, Guangdong, were retrospectively analyzed. There were 35 male and 12 female donors, aged 19-64 years, with a median of 35 years. The informed consent of donors or their family were obtained and the local ethical committee approval was received. The donors were critically and adequately assessed for general condition, and assist-control ventilation was used to maintain stable respiratory and circulatory function and homoiostasis were maintained. The donating liver and kidney were harvested by combined perfusion through transabdominal aortic and portal vein and total abdominal evisceration. Grafts were preserved by static freezing. The maintenance and use of donating organs were observed.

Continuous hemodialysis was performed in 23 cases with hyponatremia, and high doses of vasopressors were used to maintain blood pressure in 5 cases with hemodynamic instability. Continuous renal replacement therapy was performed in 2 cases due to high preoperative Scr level. 42 cases had medication history of at least one vasoactive drug. All the 47 DCD donors underwent successful organ donation and 47 livers and 94 kidneys were harvested. 44 successful liver transplantations (3 liver grafts were abandoned) and 92 successful renal transplantations (2 kidney grafts of 1 case were abandoned) were reported. Hepatic and renal function restored well after transplantation, and no primary graft failure was observed.

Adequate assessment of the general condition of DCD donors, application of effective measures to maintain organ function and keep optimal physiological balance of the donors contributes to improved organ donation rates and organ quality.