In this episode of EAST in the Arena, hosts Dr. Katie Riera and Dr. Shyam Murali, live from the 38th (2025) EAST Annual Scientific Assembly, delve into the complexities surrounding emergency department (ED) thoracotomies and organ donation with Dr. Danielle Brabender and Dr. Matt Martin from USC. They explore institutional practices, the impact on survival and organ donation rates, and the controversial aspects of balancing patient care with societal benefits. Highlighting the importance of guidelines, resource use, and the training environment, the episode provides a thorough examination of the subject's intricacies.