AUTHOR=Krendl Felix J. , Oberparleiter Silvia , Ponholzer Florian , Messner Franka , Scheidl Stefan , Maglione Manuel , Weissenbacher Annemarie , Resch Thomas , Oberhuber Rupert , Stastny Lukas , Dumfarth Julia , Seelmaier Clemens , List Wolfgang , Beer Ronny , Cardini Benno , Schneeberger Stefan , Eschertzhuber Stephan 
  
TITLE=Implementation of a controlled DCD program in Western Austria – key considerations and insights
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16147
  
DOI=10.3389/ti.2026.16147
  
ISSN=1432-2277
  
ABSTRACT=Controlled donation after circulatory death (cDCD) offers an opportunity to expand the deceased donor pool, yet implementation remains limited in many countries. We conducted a retrospective single-center analysis of all cDCD donors (Maastricht category III) referred to the Transplant Center at the Medical University of Innsbruck between January 1, 2018, and December 31, 2024. Donor characteristics, ischemia times, organ utilization, and program-level trends were analyzed. In addition, key steps and protocols essential for establishing a cDCD program were systematically evaluated. Of 56 referred cDCD donors, 53 (94.6%) proceeded to organ recovery (i.e., actual donors), and 42 (75.0%) resulted in the transplantation of at least one organ (i.e., utilized donors). Utilized donors had significantly lower BMI than non-utilized donors (25 vs. 31 kg/m2, p = 0.003). The median functional warm ischemia time was 26 min (IQR 23–28). The mean number of transplanted organs per donor was 2.06. Organ utilization rates were highest for kidneys (60.4%). Nationwide DCD activity increased from 3% to 18% following the implementation of a structured cDCD program in Western Austria. In summary, we have outlined steps and protocols required to successfully implement a cDCD program, resulting in high utilization rates and a measurable impact on national cDCD activity.