In reply: The issues raised by Rady and colleagues, Tibballs, and Kennedy include claims that antemortem interventions for organ donation after cardiac death (DCD) are harmful, involve inadequate consent procedures, and require abandoning the “dead donor rule”.

To clarify, we advocate the use of antemortem heparin in people with a known desire to be organ donors; we do not advocate potentially harmful or disruptive interventions such as femoral vessel cannulation.