Background: Although organ donation rates in Canada have improved over recent years, particularly through donation after death determined by circulatory criteria (DCC), the demand for organs continues to significantly outpace supply. This persistent shortfall highlights the urgent need to explore innovative strategies to expand donation opportunities and practices. An approach that is used internationally, donation after uncontrolled death by circulatory criteria (UDCC), involves organ recovery following unexpected cardiac arrest. While UDCC programs have been successfully implemented in several countries, they remain largely unexamined in the Canadian healthcare landscape.  This study aims to explore the perspectives of key leaders and stakeholders in the Canadian organ donation and transplantation system to better understand the factors that may influence the development and implementation of UDCC programs nationally.  
Methods: This qualitative descriptive study is currently underway and involves conducting semi-structured virtual interviews with key leaders and stakeholders in organ donation and transplantation organizations across Canada. The goal is to gather insights into the potential implementation of uncontrolled DCC programs. Interviews are being recorded, transcribed verbatim, and analyzed using an inductive approach to identify and organize recurring codes and themes that reflect participants’ perspectives.  
Preliminary Results: To date, we have conducted interviews with 19 key leaders and stakeholders across both national and provincial donation and transplantation programs, with representation from British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Nova Scotia. Preliminary analysis reveals a range of complex and inter-related challenges that could affect the feasibility of implementing UDCC programs in Canada. These include logistical barriers, ethical considerations, geographic disparities, economic constraints, and limitations in available resources and current healthcare capacity. There was a strong consensus among participants on the need for evidence-based data to assess the potential impact of such programs on donation rates. The importance of maintaining public trust and ensuring that any new initiatives align with the overarching goal of saving lives was also voiced. Some leaders identified opportunities to explore alternative pathways, such as extracorporeal membrane oxygenation (ECMO) donation and expanded tissue donation initiatives.  
Conclusion: Final results from this ongoing project will be presented at the 2025 International Society for Organ Donation Professionals Congress. Insights gained from this research have the potential to inform national conversations on pathways for supporting and advancing donation practices in Canada in unexpected circumstances.