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Updated: Oct 4, 2025
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Heart transplantation from an extended criteria donation after circulatory death donor
Ismail Vokshi1, Stephen Large1, Marius Berman1
1Transplant Unit, Royal Papworth Hospital, Cambridge, UK.
Insights
Successful heart transplantation was achieved using a reconditioned donation after circulatory death (DCD) donor heart. This case demonstrates the potential of normothermic regional perfusion for extended criteria DCD heart donors.
Area of Science:
- Cardiology
- Transplantation Surgery
- Organ Preservation
Background:
- Donation after circulatory death (DCD) heart transplantation is expanding.
- Careful selection of DCD donors is crucial due to organ viability concerns.
- Extended criteria DCD donors present unique challenges for heart transplantation.
Observation:
- A 46-year-old donor with irreversible brain injury post-aortic dissection repair was considered.
- The donor heart underwent thoraco-abdominal normothermic regional perfusion for reconditioning.
- The heart was procured using cold preservation and transplanted into a 63-year-old male recipient on extracorporeal life support.
Findings:
- The transplanted DCD heart functioned adequately in the recipient.
- The recipient required temporary mechanical circulatory support post-surgery.
- The patient achieved a successful recovery following the heart transplant.
Implications:
- This case highlights the successful use of normothermic regional perfusion to recondition an extended criteria DCD heart.
- This technique may expand the donor pool for heart transplantation.
- Further research into DCD heart reconditioning strategies is warranted.
Abstract:
Transplantation of donation after circulatory death (DCD) donor hearts is gaining acceptance. However, DCD heart selection has been understandably cautious. We report a case of reconditioning a DCD heart using thoraco-abdominal normothermic regional perfusion in a 46-year-old donor who suffered irreversible brain injury following emergency type-A aortic dissection repair. The DCD heart was procured with cold preservation and directly transplanted into a 63-year-old male who was bridged to transplant with extracorporeal life support. The recipient required a brief period of mechanical circulatory support post-transplant but made a good recovery. To our knowledge, this is the first report of successful heart transplantation from such an extended criteria DCD donor.
