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Updated: Dec 22, 2025

Pre-clinical Model of Cardiac Donation after Circulatory Death
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Cardiac donation after circulatory death.

Arjun Iyer1, Kumud Dhital1,2

  • 1Department of Cardiothoracic Surgery and Transplantation, Alfred Hospital, Melbourne, Victoria.

Current Opinion in Organ Transplantation
|May 7, 2020
PubMed
Summary
This summary is machine-generated.

Donation after circulatory death (DCD) heart transplantation is a viable option for end-stage heart failure patients, offering excellent outcomes despite initial challenges. Further research and ethical considerations are needed for wider adoption.

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Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Organ Donation

Background:

  • Increasing demand for heart transplants due to end-stage heart failure and mechanical circulatory support.
  • Limited availability of donor hearts via traditional donation after brain death pathways.
  • Growing clinical use of donation after circulatory death (DCD) donor hearts.

Purpose of the Study:

  • To review the logistics and risks associated with DCD heart donation.
  • To assess the clinical outcomes and tolerability of DCD heart transplantation.
  • To identify barriers and facilitators for wider adoption of DCD heart transplantation.

Main Methods:

  • Review of clinical utilization of DCD hearts over the past five years.
  • Analysis of associated pathophysiological consequences and logistical challenges.
  • Examination of current global adoption and future requirements for DCD heart transplantation.

Main Results:

  • DCD heart transplantation is a well-tolerated strategic alternative with excellent medium-term outcomes.
  • Delayed graft function is a notable challenge, but overall clinical outcomes are positive.
  • Current uptake is selective, limited to specific countries.

Conclusions:

  • DCD heart transplantation presents a valuable option for increasing donor heart availability.
  • Addressing ethical and clinical controversies is crucial for broader implementation.
  • Advancements in postconditioning, ischemia management, and viability assessment are key for future success.