Heart Donation From Donors After Controlled Circulatory Death

Area of Science:

• Cardiology
• Transplantation Medicine
• Surgical Innovation

Background:

• Cardiac transplantation is the gold standard for advanced heart failure.
• Historically, heart donors were primarily from brain death donors.
• Donation after circulatory death (DCD) is increasingly vital to expand the donor pool.

Purpose of the Study:

• To review the current literature on controlled donation after circulatory death (cDCD) heart transplantation.
• To summarize the pathophysiology of ischemia-reperfusion injury in cDCD hearts.
• To outline heart retrieval techniques and damage mitigation strategies for cDCD donors.

Main Methods:

• Concise literature review of cDCD heart transplant studies.
• Summary of pathophysiological mechanisms.
• Description of retrieval techniques and preservation strategies.

Main Results:

• cDCD heart transplant programs are established in several countries, including the UK, USA, and Spain.
• Understanding ischemia-reperfusion injury is crucial for successful cDCD heart transplantation.
• Various retrieval and preservation strategies aim to minimize damage to cDCD donor hearts.

Conclusions:

• Heart transplantation using DCD hearts is a continuously improving field.
• Implementation in experienced cardiac transplant centers is recommended for successful cDCD heart programs.
• cDCD offers a promising avenue to increase heart availability for transplantation.