Background: Deceased organ donation from Brain Death donors (DBD) in the United Arab Emirates began in 2017 when the UAE Ministry of Health and Prevention (MOHAP) approved the regulation on brain death declaration. The country’s unique multi-ethnic, multi-religious and multi-cultural characteristics - 88.5% of UAE population is foreign with more than 200 nationalities -presents both a challenge and an opportunity to build a deceased organ donation for transplantation system that could not only impact UAE but also the country of origin of its habitants. This paper looks for to identify the actions that have led to the development of the deceased organ donation system in the UAE.

Methods: Three levels of deceased donation structure where established, the National Transplant Committee/Center at MOHAP, the Emirates Organ and Tissue Centre (Acting as the Organ Procurement Organization) at the Department of Health of Abu Dhabi, and the hospital-based organ donation units within the major hospitals. Stakeholders’ engagement, healthcare workers training on best practice in organ donation, and the application of the DBD quality key performance indicators were the foundations for the UAE donation and transplant system implementation. Education and meetings were facilitated in collaboration with a team of international subject matter experts. 

Results: 1114 possible donors’ referrals have been received at the UAE OPO from 2017 to April 2023, although 601 had clinical suspicion of brain death, only 31% of them were confirmed death by neurological criteria. 206 families were approached with a family consent rate of 37.7%. The conversion of cases with clinical suspicion of death by neurological criteria into confirmed brain death cases and reduce family refusals (63.3%) are the two main opportunities for improvement. The UAE DBD grows from 0.3 dpmp in 2017 to 5.4 dpmp in 2022. The growing deceased donation activity in UAE has enabled organ sharing with other countries like Kuwait, Saudi Arabia and Pakistan.

Conclusions: The UAE deceased organ donation system is combining OPO model and Spanish model with hospital-based organ donation units. The collaborative approach between the healthcare system/regulators and understanding the cultural, political, and geographical local reality has proven to be a key element in developing deceased organ donation in the country.