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Updated: Jun 11, 2025

Pre-clinical Model of Cardiac Donation after Circulatory Death
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Pre-clinical Model of Cardiac Donation after Circulatory Death

Published on: August 2, 2019

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The Rapidly Evolving Landscape of DCD Heart Transplantation

Yashutosh Joshi1,2,3, Katherine Wang4, Campbell MacLean4

  • 1Heart Transplantation Unit, St Vincent's Hospital Sydney, 390 Victoria St., Darlinghurst, NSW, 2010, Australia. yashutosh.joshi@svha.org.au.

Current Cardiology Reports
|October 9, 2024
PubMed

Insights

Donation after circulatory death heart transplantation (DCD-HT) survival outcomes are comparable to brain dead donor heart transplantation (BDD-HT). Advancements in perfusion strategies are improving graft function and expanding DCD-HT viability.

Area of Science:

  • Cardiovascular Surgery
  • Transplantation Medicine
  • Organ Procurement

Background:

  • Donation after circulatory death (DCD) heart transplantation (HT) is an evolving field.
  • Standardization of procurement strategies is crucial for optimizing outcomes.
  • Advancements in organ preservation are critical for expanding the donor pool.

Purpose of the Study:

  • To review international clinical outcomes of DCD-HT.
  • To analyze the impact of various procurement strategies on DCD-HT outcomes.
  • To explore novel approaches and future research directions in DCD-HT.

Main Methods:

  • Systematic review of international clinical outcomes in DCD-HT.
  • Analysis of procurement strategies, including direct procurement and regional perfusion.
  • Evaluation of emerging technologies like normothermic and hypothermic machine perfusion.

Main Results:

  • DCD-HT survival outcomes are comparable to brain dead donor heart transplantation (BDD-HT) across different procurement strategies.
  • Normothermic machine perfusion demonstrates improved rates of primary graft dysfunction.
  • Hypothermic machine perfusion shows promising early results for directly procured DCD hearts.
  • Controlled cold ischemia may be tolerated, but minimizing ischemic time remains important.

Conclusions:

  • DCD-HT offers survival outcomes equivalent to BDD-HT.
  • Procurement strategy remains a key area for ongoing research and debate.
  • Developing methods to enhance allograft tolerance to warm ischemia is vital for future advancements, particularly for machine perfusion techniques.
Abstract

Keywords:
Donation after circulatory deathHeart transplantationHypothermic machine perfusionNormothermic machine perfusionNormothermic regional perfusion

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