Donation After Circulatory Death: A New Frontier.

Area of Science:

• Cardiology
• Transplantation Medicine
• Surgical Innovation

Background:

• Donated-cadaver (DCD) donors represent an expanding resource for heart transplantation.
• Understanding preservation strategies is crucial for optimizing outcomes with DCD hearts.

Purpose of the Study:

• To review global experiences with DCD heart transplantation.
• To compare DCD heart preservation strategies and examine early clinical outcomes.
• To discuss the increasing role of DCD donors in heart transplantation.

Main Methods:

• Review of current global DCD heart transplantation practices.
• Analysis of DCD heart preservation techniques, including normothermic machine perfusion (NMP) and traditional non-perfusion (TA-NRP).
• Examination of early clinical outcomes and graft function.

Main Results:

• DCD heart transplantation survival rates are comparable to those from brain-dead donors.
• Normothermic machine perfusion (NMP) and traditional non-perfusion (TA-NRP) are key preservation strategies.
• Asystolic warm ischemia time significantly impacts graft function and the need for mechanical support.

Conclusions:

• DCD hearts are a viable and increasingly utilized alternative to brain-dead donor hearts.
• Continued research into preservation methods and ischemic tolerance will enhance DCD heart utilization.
• DCD heart transplantation is establishing itself as a permanent component of the transplantation landscape.