Organ shortages have led some countries, including Spain, France, and the USA, to start programmes of uncontrolled donation after circulatory death.1 In these protocols, donors are people who have had unexpected out-of-hospital cardiac arrest. After ordinary life support attempts (30 min of advanced cardiopulmonary resuscitation [CPR]) by an emergency medical service are judged futile, patients are transported to the hospital with continuing mechanical chest compression and other interventions to preserve the organs, and declared dead at the hospital after a no-touch period of asystole (usually 5 min). Then, normothermic extracorporeal membrane oxygenation (ECMO) or in-situ cooling is started to preserve the organs until authorisation for donation is given by the family.
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