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Updated: Sep 4, 2025
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Donation After Circulatory Death: Expanding Heart Transplants
1Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, New York, NY.
Insights
Donation after circulatory death (DCD) heart transplants are expanding globally. Anesthesiologists play a key role in optimizing DCD heart transplantation success, addressing donor organ shortages for end-stage heart failure patients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Anesthesiology
Background:
- Heart failure impacts millions, diminishing quality of life with limited end-stage treatment options.
- Heart transplantation is preferred over mechanical support but faces donor organ scarcity.
- Donation after circulatory death (DCD) heart transplantation has seen global growth since 2014.
Purpose of the Study:
- To review the process of DCD heart transplantation.
- To highlight the critical role of anesthesiologists in DCD heart transplantation.
- To discuss opportunities for anesthesiologists to enhance DCD heart transplant outcomes.
Main Methods:
- Review of current DCD heart transplantation protocols and outcomes.
- Analysis of anesthesiologist's responsibilities and potential contributions.
- Discussion of challenges and future directions in DCD heart transplantation.
Main Results:
- DCD heart transplantation is a growing field addressing donor organ shortages.
- Anesthesiologists have unique opportunities to influence the success of DCD heart transplants.
- The US has been slower to adopt DCD heart transplantation compared to global trends.
Conclusions:
- Increasing the donor heart supply through DCD is crucial for managing end-stage heart failure.
- Anesthesiologists are integral to the successful expansion of DCD heart transplantation.
- Further research and implementation are needed to fully realize the potential of DCD heart donation.
Abstract:
Heart failure affects 6.2 million adults in the United States (US), resulting in a decrease in quality of life. Limited options exist for the treatment of end-stage heart failure. Mechanical circulatory support and transplantation are considered when no further optimization can be obtained with medical management. Heart transplant is regarded as superior to mechanical assist devices due to a lower incidence of multiorgan dysfunction. However, transplants are limited by the availability of donor organs. Heart transplants using organs from donation after circulatory death (DCD) have blossomed globally since 2014; whereas, in the US, this method has had a slower implementation. Today, the realization of the need to increase the number of donor hearts has reinvigorated the interest in heart transplantation using DCD organs. The authors review the process and discuss the unique opportunities anesthesiologists have to impact the future success of DCD heart transplantation as it continues to expand.
