Related Experiment Video
Updated: Jul 2, 2026
Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
Published on: October 11, 2022
Intraoperative Surface Echocardiography for Donor Heart Assessment During Normothermic Regional Perfusion
Kevin C McGann1, Aaron M Williams1, Ryan J Lefevre2
1From the Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Insights
Intraoperative echocardiography can confirm the suitability of Donation after Circulatory Death (DCD) hearts for transplantation when preoperative data is incomplete. This technique enhances organ utilization and expands access to life-saving heart transplants.
Area of Science:
- Cardiology
- Transplant Surgery
- Medical Imaging
Background:
- Heart transplantation is the gold standard for end-stage heart failure, but donor organ scarcity limits patient access.
- Donation after Circulatory Death (DCD) offers a promising solution to expand the donor pool.
- Incomplete preoperative diagnostic data for DCD donors presents a challenge for transplant centers.
Purpose of the Study:
- To report the utility of intraoperative surface echocardiography in assessing DCD heart suitability for transplantation.
- To demonstrate a practical strategy for overcoming incomplete preoperative diagnostic information in DCD heart recovery.
Main Methods:
- Case report detailing the use of intraoperative surface echocardiography during DCD heart recovery.
- Application of thoracoabdominal normothermic regional perfusion (TA-NRP) for organ preservation.
- Evaluation of organ suitability for transplant using echocardiography during the procurement process.
Main Results:
- Intraoperative surface echocardiography provided crucial information to confirm the suitability of a DCD heart for transplant.
- This method was effective in circumstances where preoperative echocardiography was not feasible.
- The use of TA-NRP facilitated organ recovery and assessment.
Conclusions:
- Intraoperative surface echocardiography is a valuable tool for confirming DCD heart suitability when preoperative data is limited.
- This technique can increase organ utilization rates.
- Implementing such strategies can improve access to life-saving heart transplantation.
Abstract:
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.
