Background: Organ donation from deceased donors is essential in saving lives. In the United Arab Emirates, some brain-dead donor cases are classified as medico legal (police-involved), requiring clearance from forensic authorities or public prosecution. These cases previously posed significant barriers to donation. In recent years, inter-agency collaboration and procedural efficiency have improved. As part of this effort, the National Center has actively invited police officers, forensic teams, and public prosecutors to participate in organ donation workshops and national trainings to enhance shared understanding and align with global best practices.
Objective: To review medico legal brain-dead donor cases from 2023 to mid-2025 and assess how improved coordination has helped reduce donation barriers.
Methods: A retrospective review was conducted of all medico legal brain-dead donor cases from January to June 2025 with complete data. Additional analysis included 2023–2024 cases where family consent was given, but organ retrieval did not proceed due to legal or forensic factors. Non-consented medico legal cases from 2023–2024 were not fully available.
Cases were categorized into:
• Medico legal cases with family consent but no organ retrieval
• Medico legal cases with successful organ donation
Data reviewed included demographics, cause of brain death, legal classification, consent status, police/forensic clearance, and outcome.
Results: A total of 19 eligible medico-legal brain-dead donor cases were analyzed:
• Successful donations (Group A): 14 cases (74%) proceeded to full organ retrieval. Causes included road traffic accidents, assault, burns, and drowning. Most successful donations occurred in 2025, reflecting stronger collaboration between transplant coordinators, police, and forensic teams.
•  Barriers Despite Family Consent (Group B): 5 cases (26%) had family consent for organ donation but could not proceed due to legal obstacles. Barriers included mandatory full-body autopsy, reversal of previously granted police clearance, reclassification of the case under criminal suspicion, and one undocumented family consent withdrawal. These cases were primarily from 2023–2024, with fewer observed in 2025.
Successful donations involved road traffic accidents, assault, burns, and drowning. Most occurred in 2025, reflecting closer collaboration between national center coordinators, law enforcement officers, and forensic teams. The small subset of consented but unsuccessful cases from 2023–2024 suggests that medico legal obstacles are decreasing as new clearance pathways mature.
Conclusion: This review highlights positive progress in managing medico legal donor cases in the UAE. The high rate of successful retrievals in 2025 suggests that engagement with police and forensic authorities, including participation in trainings and policy discussions, is improving donation outcomes. Continued collaboration and standardized clearance processes are key to sustaining this trend.