Related Experiment Video
Updated: Dec 28, 2025
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Heart transplantation from donation after circulatory death donors: Present and future
Mohammed Quader1, Stefano Toldo1, Qun Chen1
1Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
Insights
Expanding heart transplantation eligibility by considering donation after circulatory death (DCD) could increase donor heart availability. This review compares DCD with donation after brain death (DBD) to enhance transplant numbers.
Area of Science:
- Cardiology
- Transplantation Medicine
- Surgical Innovation
Background:
- Human heart transplantation, a life-saving procedure, faces donor organ scarcity, with 20% of patients dying before receiving a transplant.
- Current heart procurement relies on donation after brain death (DBD), a practice that has evolved over time.
- Early heart transplants utilized organs from donors experiencing circulatory death.
Purpose of the Study:
- To review the distinctions between donation after brain death (DBD) and donation after circulatory death (DCD) heart donation.
- To explore the potential of increasing donor heart availability by including donation after circulatory death (DCD).
- To summarize research pertinent to expanding heart transplantation through DCD donors.
Main Methods:
- Comparative review of donation after brain death (DBD) and donation after circulatory death (DCD) protocols.
- Analysis of historical and current practices in heart procurement.
- Synthesis of research findings on DCD heart transplantation viability.
Main Results:
- Identifies key differences in physiological parameters and organ preservation between DBD and DCD heart donation.
- Highlights the potential for DCD to significantly increase the pool of available donor hearts.
- Discusses challenges and considerations for implementing DCD heart donation.
Conclusions:
- Revisiting donation after circulatory death (DCD) presents a viable strategy to address donor heart shortages.
- Expanding heart transplantation criteria to include DCD donors can save more lives.
- Further research and protocol refinement are essential for successful DCD heart transplantation.
Abstract:
The first successful human heart transplantation was reported on 3 December 1967, by Christiaan Barnard in South Africa. Since then this life-saving procedure has been performed in over 120 000 patients. A limitation to the performance of this procedure is the availability of donor hearts with as many as 20% of patients dying before a donor's heart is available for transplant. Today, hearts for transplantation are procured from individuals experiencing donation after brain death (DBD). Interestingly, this, however, was not always the case as the first heart transplants occurred after circulatory death. Revisiting the availability of hearts for transplant from those experiencing donation after circulatory death (DCD) could further expand the number of hearts suitable for transplantation. There are several considerations pertinent to transplanting hearts from those undergoing circulatory death. In this review, we summarize the main distinctions between DBD and DCD heart donation and discuss the research relevant to increasing the number of hearts available for transplantation by including individual's hearts that experience circulatory death.
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