Spanish Center's Early Experience With Donation Following Circulatory Death in Heart Transplantation

Area of Science:

• Cardiology
• Transplantation Medicine
• Surgical Innovation

Background:

• Donation after circulatory death (DCD) heart transplantation is re-emerging as a strategy to increase donor organ availability.
• While promising, the clinical outcomes of DCD heart transplants require thorough evaluation compared to traditional donation after brain death (DBD) methods.

Purpose of the Study:

• To compare the clinical outcomes of heart transplantation using DCD versus DBD donors.
• To assess the impact of DCD donation on graft availability and patient survival.

Main Methods:

• A retrospective analysis of adult patients undergoing isolated heart transplantation between 2012 and 2023.
• Comparison of patient demographics, pre-transplant characteristics, and early post-operative outcomes between DCD and DBD graft recipients.

Main Results:

• DCD donors were more frequently local, and recipients required fewer ventricular assist devices and less urgent status.
• DCD grafts experienced significantly shorter myocardial ischemia and extracorporeal circulation times.
• No significant differences were observed in primary graft failure or hospital mortality between DCD and DBD groups.

Conclusions:

• Cardiac transplantation using DCD donors yields hospital outcomes comparable to DBD donors.
• Further long-term follow-up is essential to evaluate rejection, graft vascular disease, and overall mortality in DCD heart recipients.