“The proportion of [donation after circulatory death donors (DCD)] in the US increased from 2% in 2000 to 49% in 2025, a period in which the number of DCD donors increased from 118 in 2000 to 8129 in 2025, while donation after [brain death donors (DBD)] rose from 5,849 to 8416…

DCD donors now comprise about half of DD, including most donors at 44% of OPOs. Further, contemporary DCD donors are more medically complex than those from prior eras. This growing reliance on DCD organs to maintain transplant access necessitates establishing best practices in DCD organ selection, preservation, and allocation. Recent innovations have facilitated recovery from medically complex DCD donors. Normothermic regional perfusion, in which perfusion is restored in situ to limited organs after circulatory death, contributed to the rise in recovery of DCD organs since its use began increasing in 2019. The regulatory approval of normothermic machine perfusion for livers (2021) contributed to the subsequent acceleration of DCD liver recovery, and normothermic machine perfusion enabled the advent of DCD heart transplantation in 2019.”

From JAMA.