Related Experiment Video
Updated: May 5, 2026
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Comparing Mid-Term Outcomes of Donation After Brain Death and Donation After Circulatory Death Orthotopic Heart
Mansimran Singh Dulay1,2, Amira Bhaiji1, Nahal Raza1,2
1Harefield Hospital (Royal Brompton and Harefield Hospitals, part of Guy's and St Thomas' NHS Foundation Trust), London, UK.
Insights
Outcomes for heart transplants using organs from donors after circulatory death (DCD) are similar to those from donors after brain death (DBD). This study supports using DCD organs to help meet the growing demand for heart transplantation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Organ Donation
Background:
- Global shortage of donor hearts for transplantation.
- Increasing waitlist numbers worldwide.
- Orthotopic cardiac transplantation (OCTx) utilizes organs from donors after brain death (DBD) or circulatory death (DCD).
Purpose of the Study:
- To compare patient outcomes following OCTx using DBD versus DCD donor hearts.
- To evaluate short-term and mid-term outcomes in matched patient cohorts.
Main Methods:
- Matched cohort study comparing 44 DCD and 33 DBD OCTx patients.
- Outcomes assessed up to 1 year (short-term: PGD, ICU stay) and 5 years (mid-term: mortality, rejection, graft function).
- Patient data collected from Harefield Hospital between 2012 and 2023.
Main Results:
- No significant differences in baseline characteristics between DBD and DCD groups.
- Similar short-term and mid-term outcomes observed in both cohorts.
- Event-free survival regarding all-cause mortality was not significantly different between groups.
Conclusions:
- Single-center UK data shows comparable outcomes for OCTx using DBD and DCD organs.
- Findings support the use of DCD organs to address worldwide organ shortages.
- Further research can bolster evidence for DCD organ utilization in heart transplantation.
Introduction:
The number of patients on heart transplant waitlists is growing globally, with an insufficient number of organ offers to meet this growing demand. To help improve patient outcomes, in the United Kingdom (UK), orthotopic cardiac transplantation (OCTx) can occur using hearts donated following donor brain death (DBD) or donor circulatory death (DCD). The aim of this paper was to compare outcomes between groups of DBD and DCD OCTx patients at Harefield Hospital.
Methods:
44 DCD patients (transplanted between 2012 and 2023) were matched (with outcomes blinded, by age and gender) with 33 DBD patients (transplanted between 2015 and 2023). Short-term outcomes (up until 1-year posttransplants, including outcomes such as primary graft dysfunction [PGD] and length of intensive care unit [ICU] stay) and midterm outcomes (up until 5 years posttransplant, including outcomes such as all-cause-mortality, episodes of rejection and graft left ventricular function) were assessed.
Results:
Overall, no significant differences were noted with regard to baseline characteristics, and outcome measures (both short and mid-term outcomes) between the matched DCD and DBD cohorts. Event-free survival with regard to all-cause mortality also remained not significantly different between both groups (log-rank p < 0.756).
Conclusion:
In conclusion, our single-center UK data did not demonstrate any differences in outcomes between DCD and DBD OCTx patients. We add to growing literature that would support DCD organ use in heart transplantation, in an effort to reduce growing organ demand worldwide.
