Bill to introduce donation after circulatory death

Move aims to shift Korea's transplant system beyond brain-death donors

Rep. Seo Young-seok of the Democratic Party of Korea [provided by the lawmaker's office]
Rep. Seo Young-seok of the Democratic Party of Korea [provided by the lawmaker's office]

Rep. Seo Young-seok of the Democratic Party of Korea, who represents Bucheon-gap in Gyeonggi Province and sits on the National Assembly's Health and Welfare Committee, announced Tuesday that he had introduced a bill to amend the Act on the Management of Organs to establish a donation after circulatory death (DCD) system — opening the door to organ donation by patients who have withdrawn life-sustaining treatment.

South Korea's organ transplant system currently relies almost entirely on brain-dead donors. From 2020 to 2024, the number of patients on transplant waiting lists grew by roughly 2,900 a year, while the donor pool stagnated — leaving about eight patients dying every day while waiting for a transplant.

According to Seo, the Ministry of Health and Welfare moved to address this structural shortfall in October 2025, releasing its first five-year comprehensive plan for organ donation and transplantation (2026–2030), which identified expanding donation methods — including DCD — as a core priority.

The bill provides the legislative foundation to carry out that policy direction. Its central aim is to revise the legal framework so that patients who have decided to withdraw life-sustaining treatment can also donate their organs.

Specifically, the bill establishes a procedure requiring organ procurement organizations to be notified when a patient — who has expressed a wish to donate while alive, or whose family has expressed that wish — begins the process of withdrawing life-sustaining treatment. The bill also sets a legal definition of death for DCD donors as the point five minutes after the irreversible cessation of spontaneous circulation and respiration.

DCD, which permits organ donation following cardiac arrest, is already institutionalized in leading transplant nations including Spain, the United States and the United Kingdom, where DCD donations account for nearly half of all organ donations and have played a key role in expanding the donor pool and improving transplant rates.

Meanwhile, the social foundation for respecting individual end-of-life decisions is growing in South Korea, with more than 3.3 million people having registered advance directives on life-sustaining treatment. Linking the life-sustaining treatment withdrawal system with organ donation is expected to ease the transplant backlog and give more patients a second chance at life.

"The current structure, which depends solely on brain-dead donors, cannot keep pace with rising transplant demand," Seo said. "We need to build an institutional foundation that rationally connects the withdrawal of life-sustaining treatment with organ donation to save more lives. Introducing the DCD system will be a turning point — one that respects patients' right to self-determination while expanding the social solidarity that saves others."


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