Over the last decade, a novel method of organ donation after circulatory death (DCD) known as normothermic regional perfusion (NRP) has come into widespread use in various European countries. Although DCD is well established in the U.S., NRP has generated significant controversy, and the American College of Physicians (ACP) has issued a statement recommending a freeze on its implementation until outstanding ethical concerns are more thoroughly resolved. At the center of the controversy is the contention that NRP kills the donor. In its “controlled” form (cDCD), donation after circulatory death follows a request by a patient with a do-not-resuscitate order (DNR) or a surrogate decision-maker for such a patient to withdraw life-sustaining treatments (LSTs) due to a poor prognosis. Once LSTs are withdrawn and the patient sustains cardiac arrest, physicians wait for five minutes before declaring the patient dead based on circulatory criteria. In “standard” cDCD, surgeons rapidly retrieve organs and place them in cold storage. Unfortunately, however, organs tend to suffer damage during the five-minute “hands-off period” following cardiac arrest when they are deprived …