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Updated: Feb 17, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
The need and opportunity for donation after circulatory death worldwide
Martí Manyalich1, Helen Nelson2, Francis L Delmonico3
1Hospital Clinic de Barcelona, University of Barcelona, TPM-DTI Foundation, Barcelona, Spain.
Insights
Expanding deceased donation after circulatory death (DCD) is crucial for addressing the global organ shortage. Further research into DCD heart and liver transplantation is recommended to meet transplant needs.
Area of Science:
- Transplantation Medicine
- Organ Donation Research
Background:
- Global organ transplant demand significantly exceeds supply, with current transplantation rates meeting only 10% of the worldwide need.
- Deceased donation following brain death determination (DBD) alone is insufficient to bridge this gap.
Purpose of the Study:
- To evaluate the potential for expanding deceased donation after circulatory death (DCD).
- To assess the effectiveness of donor registries in facilitating DCD.
- To review current clinical research on heart, lung, and liver transplantation from DCD donors.
Main Methods:
- Analysis of unrealized DCD potential.
- Evaluation of DCD's impact on DBD cases.
- Review of donor registry effectiveness for DCD.
- Synthesis of existing clinical research on DCD organ transplantation.
Main Results:
- DCD expansion is a viable strategy to increase organ availability.
- Donor registries can enhance DCD rates.
- Successful kidney and lung transplantation from DCD donors indicate potential for heart and liver transplants.
Conclusions:
- Deceased donation after circulatory death (DCD) is essential for addressing the organ shortage.
- Implementing DCD programs is feasible globally.
- Future efforts should focus on expanding DCD for heart and liver transplantation, alongside ex-vivo organ repair technologies.
Purpose Of Review:
The global shortage of organ donors will not be resolved solely by relying on deceased donation following a brain death determination (DBD). Expansion of deceased donation after circulatory death (DCD) will be needed to address the shortfall of organs for transplantation. Approximately 120 000 organ transplants are performed each year; however, the WHO estimates that this number of transplants only resolves 10% of the annual worldwide transplant need.
Recent Findings:
The report addresses the opportunity of DCD expansion by evaluating the DCD potential that is not being realized, the utility of DCD enabling DBD to emerge in some clinical situations, by the effectiveness of a donor registry in achieving DCD, and by the current clinical research of heart, lung, and liver transplantation from DCD.
Summary:
The future of deceased donation must include DCD and ex-vivo organ repair if the organ shortage is to be reconciled even partially to the ongoing demand. Although the religious and legal impediments have been overcome to determine brain death, the possibility of DCD has not been addressed. A program of DCD is feasible in all countries with transplantation services. The excellent results following kidney and lung transplantation suggest opportunities of heart and liver transplantation should be the focus of needed DCD accomplishment in the near future.
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