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A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
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A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death

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Establishing a heart transplant programme using donation after circulatory-determined death donors: a United Kingdom

Vipin Mehta1, Marcus Taylor1, Joanne Hasan1

  • 1Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK.

Interactive Cardiovascular and Thoracic Surgery
|May 18, 2019
PubMed

Insights

Donation after circulatory-determined death (DCD) heart transplants offer a safe alternative to increase donor supply. Our program achieved 100% 30-day survival, boosting transplant activity by 23%.

Area of Science:

  • Cardiology
  • Transplantation Surgery
  • Organ Donation

Background:

  • Global demand for heart transplant donors exceeds supply.
  • Donation after circulatory-determined death (DCD) is a viable alternative for increasing organ availability.
  • Establishing DCD heart transplant programs is crucial for addressing donor shortages.

Purpose of the Study:

  • To present the initial experience of a new DCD heart transplant program.
  • To evaluate the safety and efficacy of DCD heart transplantation.
  • To assess the impact of a DCD program on overall transplant activity.

Main Methods:

  • Single-center retrospective observational study.
  • Procurement of DCD hearts using direct procurement and perfusion.
  • Ex vivo machine perfusion using the TransMedics® Organ Care System.

Main Results:

  • Seven DCD hearts were successfully implanted between May 2017 and December 2018.
  • The DCD program increased transplant activity by 23% compared to brainstem death donors.
  • Achieved 100% 30-day and 86% 90-day survival rates for DCD heart recipients.

Conclusions:

  • DCD heart transplantation is a safe and effective strategy to increase heart transplant volume.
  • Institutions with established transplant programs can safely implement DCD heart transplant programs.
  • Widespread adoption of DCD heart transplantation can significantly improve patient access to life-saving procedures.
Abstract

Keywords:
Donation after circulatory-determined death (DCD)Heart transplantationOrgan Care System (OCS)TransMedics®

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