Purpose: This pilot program evaluated the effectiveness of a collaborative initiative between a hospice provider, an organ procurement organization (OPO), and a hospital to optimize organ donation opportunities for hospice patients through the donation after circulatory death (DCD) process. We hypothesized that an integrated approach to early identification and management of eligible hospice patients would enhance donation opportunities and improve the end-of-life experience for both patients and families.
Methods: A pilot program was implemented between a hospice provider, a hospital, and an OPO. This collaboration involved early identification of eligible hospice patients and donation triggers, with referrals initiated by hospital staff to both hospice and the OPO. Partners coordinated logistics for organ donation, medical management, pronouncing provider, and ensured timely and respectful withdrawal of life-sustaining measures. Data on patient referrals, organ donations, and family support have been collected since the program’s initiation on August 20, 2024.
Results: Since the launch of the Hospice/DCD Pilot Program through to 5/20/25, 24 cases have been managed. Of these, 12 donors passed within the time frame, resulting in the successful transplant of 11 livers and 18 kidneys. The 12 donors who did not pass in time, continued hospice care. Collaboration among frontline staff, families, and stakeholders has been overwhelmingly positive, contributing to the program’s success.
Conclusions: The Hospice Pronouncing Pilot Program has expanded donation opportunities and improved the end-of-life experience for patients and families. By integrating hospice care, hospital services, and organ procurement, the program offers a holistic approach to DCD donation. This model provides additional options for pronouncing providers, enhances family support during end-of-life care, and ensures appropriate comfort measures managed by hospice providers. These findings suggest that fostering partnerships across healthcare settings can increase organ donation rates while providing families and the donor with a compassionate and dignified end-of-life experience.