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Updated: Jan 18, 2026
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Preclinical Modeling of DCD Class III Donation: Paving the Way for the Increased Use of This Challenging Donor Type
David Soussi1,2,3, Xavier Rod1,4, Raphael Thuillier1,2,5
1Inserm U1082, Poitiers, F-86000, France.
Insights
Researchers developed a pig model to accurately mimic Deceased after circulatory death (DCD) Class III donor conditions. This model will help explore new strategies to improve organ quality and transplantation outcomes.
Area of Science:
- Organ transplantation research
- Surgical innovation
- Animal modeling
Background:
- Deceased after circulatory death (DCD) donors, especially Maastricht Class III, are crucial for addressing organ shortages.
- Current DCD donor utilization is limited, and expanding criteria may compromise organ quality.
- Scientific exploration is needed to optimize DCD donor management and prepare for future challenges.
Purpose of the Study:
- To develop and validate a Large White pig model that accurately replicates clinical Deceased after circulatory death (DCD) Class III conditions.
- To establish a controlled experimental platform for investigating novel therapeutic strategies for DCD donors.
Main Methods:
- Mimicked clinical Deceased after circulatory death (DCD) Class III conditions in a Large White pig model.
- Employed specific animal positioning and ventilator settings.
- Utilized pharmacological interventions to manage blood pressure and heart rate.
- Assessed perfusion pressures and functional warm ischemia times.
Main Results:
- Successfully reproduced Deceased after circulatory death (DCD) Class III conditions with perfusion pressures and warm ischemia closely resembling clinical scenarios.
- Detailed the functional and histological impacts of the established model.
- Identified an optimal combination of technical and pharmacological factors.
Conclusions:
- The developed pig model provides a valuable platform for studying Deceased after circulatory death (DCD) Class III donor management.
- This model can facilitate research into novel therapeutics such as normothermic regional perfusion and pharmacological interventions.
- It is critical for exploring strategies to enhance organ quality and transplantation success from DCD donors.
Abstract:
Deceased after circulatory death (DCD) donors offer a viable solution to the current organ shortage, particularly the Maastricht Class III (arrest subsequent to cessation of life support in the hospital). Although current results from these donors are very satisfactory, the number of included donors is too low and future expansion of inclusion criteria will likely decrease organ quality, with negative consequences on the complication rate. This donor type thus represents a priority in terms of scientific exploration, so as to study it in controlled settings and prepare for future challenges. Hence, we mimicked the DCD Class III clinical conditions a Large White pig model. Herein, we detail the different strategies attempted to attain our objectives, including technical approaches such as animal positioning and ventilator settings, as well as pharmacological intervention to modulate blood pressure and heart rate. We highlight the best combination of factors to successfully reproduce DCD Class III conditions, with perfusion pressures and functional warm ischemia (hypoperfusion) closely resembling clinical situations. Finally, we detail the functional and histological impacts of these conditions. Such a model could be of critical value to explore novel management alternative for these donors, presenting a uniquely adapted platform for such therapeutics as normothermic regional circulation and/or pharmacological intervention.
