Related Experiment Video
Updated: Jan 6, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Outcomes of heart transplantation using ECMO-supported donation in brain dead donors
Soojin Lee1, Seunghwan Song2, Hye Won Lee3
1Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea.
Insights
Extracorporeal membrane oxygenation (ECMO) effectively supports donation after brain death (DBD) donors, improving heart transplant rates. Recipients showed excellent 1-year survival, indicating ECMO
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Critical Care Medicine
Background:
- Extracorporeal membrane oxygenation (ECMO) is utilized in South Korea to optimize heart utilization from donation after brain death (DBD) donors.
- The effectiveness of ECMO in DBD donors and subsequent heart utilization rates remain under-investigated.
- This study evaluates early outcomes of heart transplantation from ECMO-supported DBD donors.
Purpose of the Study:
- To analyze early postoperative outcomes of heart transplant recipients from ECMO-supported DBD donors.
- To identify factors influencing successful heart transplantation from ECMO-supported DBD donors.
- To assess the efficacy of ECMO in enhancing heart utilization from DBD donors.
Main Methods:
- Retrospective analysis of 16 DBD donors supported by ECMO between 2013 and 2024.
- Comparison of preoperative donor characteristics between successfully transplanted (n=3) and non-utilized (n=13) hearts.
- Evaluation of recipient preoperative, intraoperative, and 1-year postoperative outcomes.
Main Results:
- Out of 190 DBD donors, 16 (8.4%) received ECMO support; 3 (18.8%) hearts were transplanted.
- One-year graft and recipient survival rates were 100% for transplanted hearts.
- Transplanted donors were significantly younger (median age difference 26 years, p=0.031) than non-transplanted donors.
Conclusions:
- ECMO can be effectively employed in DBD donors to increase heart transplant rates.
- Heart transplantation from ECMO-supported DBD donors yields satisfactory early postoperative outcomes.
- Younger age is a favorable characteristic for heart utilization in ECMO-supported DBD donors.
Background:
In South Korea, extracorporeal membrane oxygenation (ECMO) is used as a bridge to optimize utilization of heart obtained from donors after brain death. However, the heart utilization rate and the effectiveness of ECMO in donation after brain death (DBD) donors, prior to donation, remain unclear. This study aimed to analyze the early postoperative outcomes of recipients who received hearts from DBD donors supported by ECMO, and to identify the factors associated with successful transplantation outcomes.
Methods:
Donors who received ECMO support were divided into two groups, one, whose hearts were successfully transplanted (n = 3), and the other, whose hearts were not utilized for transplantation (n = 13), at our institution between 2013 and 2024. Preoperative donor characteristics of the two donor groups were compared to identify the factors influencing successful heart transplantation. Recipients' preoperative, intraoperative findings, and 1-year postoperative outcomes were analyzed.
Results:
Among 190 DBD donors, 16 (8.4%), supported by ECMO, were grouped. The transplanted heart rate in this group was 18.8% (3 out of 16 ECMO-supported potential donors). The 1-year graft survival and recipient survival rates were 100%. The transplanted donor group tended to be younger than the non-transplanted group, with a median age difference of 26 years (p = 0.031).
Conclusion:
Prior to donation, ECMO can be effectively used in brain-dead donors, to improve the rate of heart transplants. The postoperative outcomes of recipients, who received hearts procured from ECMO-supported donors, were satisfactory. Among ECMO-supported DBD donors, the median age tended to be lower in the transplanted donor group.
