Quantifying the duration and variability of thoracic organ procurement cases

To quantify and analyze key temporal intervals and variability in heart and lung thoracic organ procurement using multicenter registry data and assessing logistical complexity across operational phases and preservation modalities to inform strategies for optimizing transplant efficiency.

This retrospective study analyzed timestamp data from 25,935 events across 7665 thoracic organ procurement cases (4992 heart, 2673 lung) performed between 2021 and 2025 using the Paragonix Mobile Application. Four temporal intervals were examined: total time away from transplant center, time at donor location, time to organ acceptance, and organ explant duration. Cases were stratified by organ type (heart and lung) and donor type (donation after brain death and donation after circulatory death).

Median total time away from transplant center was 7.4 hours for heart and 8.5 hours for lung procurement. Time at donor location showed was similar for each organ type (heart 3.2 hours vs lung 3.4 hours). Acceptance time demonstrated the shortest medians (heart 0.5 hours vs lung 0.8 hours). Organ explant duration was consistent (heart 2.0 hours vs lung 2.1 hours). All intervals exhibited right-skewed distributions with outliers. Donation after circulatory death cases demonstrated shorter surgical intervals compared with donation after brain death cases.

This analysis provides empirical benchmarks for thoracic organ procurement timelines, revealing substantial real-world variability while demonstrating comparable durations between heart and lung procurement. These data may inform resource-allocation strategies, suggest a role for third-party procurement services, and optimize workflows for expanding donation after circulatory death programs.