Emil J. N. Busch argues that the use of normothermic regional perfusion (NRP) in controlled donation after circulatory determination of death (cDCDD) does not violate the dead donor rule (DDR) or resuscitate the donor. The main concern raised by the American College of Physicians (ACP) is that NRP may violate the circulatory criterion for determining death by resuscitating the donor. However, Busch contends that the circulatory criterion is meant to determine whether the organism as a whole has died, not just the brain. In NRP-cDCDD, circulation is resumed in parts of the donor's body, but blood flow to the brain is excluded, which means the donor is not resuscitated. The circulatory criterion is based on the organism's ability to function as a whole, and the exclusion of brain circulation in NRP-cDCDD ensures that the donor is not revived. Busch also emphasizes that the no-touch period following cardiac arrest is sufficient to determine death, and that the use of NRP does not change this. Therefore, the circulatory criterion is not violated in NRP-cDCDD, and the donor is not resuscitated. The article concludes that the ACP's concerns about NRP-cDCDD are unfounded.Emil J. N. Busch argues that the use of normothermic regional perfusion (NRP) in controlled donation after circulatory determination of death (cDCDD) does not violate the dead donor rule (DDR) or resuscitate the donor. The main concern raised by the American College of Physicians (ACP) is that NRP may violate the circulatory criterion for determining death by resuscitating the donor. However, Busch contends that the circulatory criterion is meant to determine whether the organism as a whole has died, not just the brain. In NRP-cDCDD, circulation is resumed in parts of the donor's body, but blood flow to the brain is excluded, which means the donor is not resuscitated. The circulatory criterion is based on the organism's ability to function as a whole, and the exclusion of brain circulation in NRP-cDCDD ensures that the donor is not revived. Busch also emphasizes that the no-touch period following cardiac arrest is sufficient to determine death, and that the use of NRP does not change this. Therefore, the circulatory criterion is not violated in NRP-cDCDD, and the donor is not resuscitated. The article concludes that the ACP's concerns about NRP-cDCDD are unfounded.