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Donor selection in the modern era

Kiran K Khush1

  • 1Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California, USA.

Annals of Cardiothoracic Surgery
|March 2, 2018
PubMed

Insights

The demand for donor hearts exceeds supply, leading to the use of "expanded criteria" donor hearts. Research reviews current data and suggests strategies to increase the donor pool for heart transplantation.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Organ Donation

Background:

  • Increasing disparity between donor heart supply and demand for transplantation.
  • Liberalization of donor heart acceptance criteria over recent decades.
  • Routine use of hearts from donors with specific conditions (e.g., LVH, cocaine use, CPR).

Purpose of the Study:

  • Review recent data on the utilization of "expanded criteria" donor hearts.
  • Propose methods to expand the donor heart pool.
  • Discuss emerging tools and ethical considerations in donor heart acceptance.

Main Methods:

  • Review of recent scientific literature and clinical data.
  • Analysis of outcomes associated with expanded criteria donor hearts.
  • Exploration of novel donor sources and acceptance strategies.

Main Results:

  • Expanded criteria donor hearts are increasingly utilized, expanding the donor pool.
  • Potential for increasing donor pool through hepatitis C donors and circulatory death determination.
  • Emerging role of donor biomarkers and risk scores in decision-making.

Conclusions:

  • Expanded criteria donor hearts are a viable option to address organ shortages.
  • Further strategies are needed to increase donor pool, including novel sources.
  • Ethical considerations regarding donor information sharing require careful deliberation.

Keywords:
Heart transplantbiomarkersdonorrisk scoresselection

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