Foundations for consensus on establishing a unified definition of death: results of the European Society for Organ Transplantation Bucharest International Consensus Conference.

As part of the ESOT International Consensus on Controlled Donation After Circulatory Determination of Death (cDCDD) Project, a dedicated working group addressed considerations relating to the determination of death in the context of cDCDD. Delphi methodology was used to explore international perspectives on the definition of death, and clinical and ethical standards for the determination of death in the setting of cDCDD. The results indicated consensus that establishing a "single unified definition of death worldwide" and specifically the "unifying brain-based concept of death" would be beneficial. There was consensus on the proposed definition of this concept and several principles relating to the determination of death in the context of cDCDD, such as the "dead donor rule." However, limited agreement was reached on the more practical aspects of death determination. The results nevertheless provide a foundation for current policy and practice and should guide further efforts to establish minimum clinical standards for the determination of death in the context of cDCDD.