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Updated: Sep 9, 2025
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Innovative strategies to increase cardiac donor availability
Benjamin Alexander1, Herra Javed1, Anshaal Furrukh1
1Department of Cardiothoracic Surgery, Arkansas Children's Hospital, Little Rock, AR 72202, United States.
Insights
Innovation is crucial to increase donor hearts for transplantation. Strategies like donation after cardiac death and xenotransplantation aim to meet the growing demand for life-saving heart transplants.
Area of Science:
- Cardiology
- Transplantation Medicine
- Organ Donation
Background:
- Heart transplantation is a critical life-saving procedure globally.
- Adult heart transplant volumes increased in the US in 2024, while pediatric volumes hit a decade low.
- Limited organ availability is a significant barrier to increasing heart transplant volume.
Purpose of the Study:
- To highlight the critical need for innovation in increasing donor organ supply for heart transplantation.
- To review current and proposed strategies aimed at expanding the donor organ pool.
- To emphasize the potential impact of these innovations on patients awaiting transplants.
Main Methods:
- Review of current organ donation and transplantation strategies.
- Analysis of trends in adult and pediatric heart transplantation volumes.
- Exploration of novel approaches to increase organ availability.
Main Results:
- Existing strategies like donation after cardiac death and ABO-incompatible transplantation have expanded the donor pool but not met demand.
- Pediatric heart transplantation volume has significantly decreased.
- Several innovative strategies are proposed to address organ scarcity.
Conclusions:
- Continued innovation is essential to overcome organ donor limitations in heart transplantation.
- Strategies such as partial heart transplantation, legislative changes, and xenotransplantation show promise.
- Refinement of these approaches is vital for improving outcomes for patients needing heart transplants.
Abstract:
Heart transplantation is a life-saving procedure for many people throughout the world. Data shows that in 2024, there was an increase in the volume of adult heart transplantation in the United States even as there was a decrease in the volume of pediatric heart transplantation to the lowest volume in a decade. Organ availability remains a major limiting factor affecting transplant volume. This mandates that innovation must take place to increase the supply of donor organs. While some strategies such as donation after cardiac death, hepatitis C virus + transplantation, and ABO-incompatible transplantation have increased the pool for donation, it still falls short of meeting the demand. Other proposed strategies include splitting the donor heart to provide multiple partial heart transplants, domino partial heart transplantation, changes in legislation including opt-out legislation, and xenotransplantation. Further evolution and refinement of these strategies will make a meaningful impact on patients awaiting life-saving heart transplants.
