Related Experiment Video
Updated: Jan 11, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Donation after circulatory determination of death heart transplantation using simplified direct procurement:
Ioannis Dimarakis1, Bassel Al-Alao1, Charlene Tennyson1
1Division of Cardiothoracic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington.
Insights
A simplified direct procurement strategy for Donation after Circulatory Death (DCD) heart transplantation using oxygenated cold blood perfusion shows promising early outcomes. This less resource-intensive method achieved successful transplants with normal graft function and no rejection.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Organ Procurement
Background:
- Donation after Circulatory Death (DCD) heart transplantation often involves complex and resource-intensive reanimation techniques.
- Existing methods like normothermic regional perfusion present logistical challenges.
- A simplified direct procurement strategy was developed to address these limitations.
Purpose of the Study:
- To evaluate the early outcomes of a simplified direct procurement strategy for DCD heart transplantation.
- To assess the feasibility and efficiency of oxygenated cold blood perfusion without reanimation.
- To determine if this method is a viable alternative to current DCD heart recovery protocols.
Main Methods:
- A streamlined direct procurement protocol was applied to five DCD heart donors.
- Hearts were flushed with oxygenated cold blood perfusion and a preservation solution, bypassing reanimation.
- Standard transplantation and short-term follow-up assessments of graft function and rejection were performed.
Main Results:
- All five DCD heart transplantations were successfully completed.
- Recipients demonstrated normal postoperative graft function without rejection during the follow-up period.
- The simplified procurement was feasible, operationally efficient, and less resource-dependent.
Conclusions:
- This simplified direct procurement technique using oxygenated cold blood perfusion is a promising approach for DCD heart recovery.
- It offers a potentially cost-effective alternative, potentially expanding the DCD donor pool.
- The method simplifies procurement and mitigates logistical constraints in DCD heart transplantation.
Background:
Donation after circulatory death (DCD) heart transplantation commonly relies on normothermic regional perfusion or ex vivo reanimation, both of which can be resource-intensive and operationally complex. To simplify procurement and mitigate logistical constraints, a direct procurement strategy employing oxygenated cold blood perfusion without reanimation was introduced. This study describes the early outcomes associated with this simplified technique.
Methods:
A streamlined direct procurement protocol was implemented in five DCD heart donors. Hearts were recovered without the use of normothermic regional perfusion and were instead flushed with oxygenated cold blood perfusion followed by a standard preservation solution. Transplantation was performed using conventional implantation methods. Postoperative graft function, rejection events, and early clinical outcomes were assessed during short-term follow-up.
Results:
All five transplant procedures were successfully completed. Recipients exhibited normal postoperative graft function with no evidence of rejection during the short-term follow-up period. The simplified procurement method proved feasible, operationally efficient, and less resource-dependent than existing reanimation-based techniques. Early results indicate that this approach may represent a cost-effective alternative for DCD heart recovery and may contribute to expanding the DCD donor pool.
