Intraoperative Surface Echocardiography for Donor Heart Assessment During Normothermic Regional Perfusion

Heart transplantation continues to be the definitive treatment for end-stage heart failure, but organ availability limits access nationwide. Donation after circulatory death (DCD) hearts have shown tremendous promise as a viable avenue for expanding the donor pool. Still, the expanded utilization of DCD hearts has introduced new challenges that evaluating centers must work to address. Among these is the frequently variable and incomplete diagnostic information available on DCD donors before organ procurement. In this case report, we highlight the role of intraoperative surface echocardiography as a practical strategy for confirming organ suitability for transplant during DCD heart recovery with thoracoabdominal normothermic regional perfusion (TA-NRP). In specific circumstances where preoperative echocardiography is not feasible, but other diagnostic data support organ suitability for transplant, intraoperative surface echocardiography may serve as a valuable tool to increase organ utilization and improve access to life-saving transplantation.