Related Experiment Video
Updated: Sep 16, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
National 6-Year Experience of Transplantation using Donor Hearts after Circulatory Death
Peter D Cho1, Tal Kibel1, Amresh Raina2
1Drexel University College of Medicine, Philadelphia, PA, USA.
Background:
While the use of donation after circulatory death (DCD) hearts for heart transplantation (HTx) has expanded notably in the United States, long-term outcomes remain poorly characterized. This study aimed to assess national 5-year survival following DCD HTx.
Methods:
We queried the United Network for Organ Sharing database to identify adult heart transplant recipients from December 2019 to December 2025. Patients were stratified based on donor type: DCD vs donation after brain death (DBD). Baseline characteristics and peri-operative outcomes, including severe primary graft dysfunction (PGD; data captured from 9/2023-12/2025) and 30-day mortality, were compared. The Kaplan-Meier method was used to evaluate 5-year survival post-transplant.
Results:
A total of 19,432 adult heart transplants were performed during the study period, with 13.3% (n=2,588) from DCD donors. Recipients of DCD hearts were less likely to be on extracorporeal membrane oxygenation (3.9% vs 8.1%, p<0.001), and donors of DCD hearts were younger (33 vs 34 years, p<0.001) than those of DBD hearts. Following transplantation, recipients of DCD hearts had a higher incidence of severe PGD (10.3% vs 5.3%, p<0.001) than those of DBD hearts, but experienced similar 30-day mortality (2.8% vs 2.7%, p=0.80) and 5-year survival (77.3% vs 78.3%, p=0.90).
Conclusions:
DCD HTx offers comparable long-term survival to DBD HTx, despite higher severe PGD. These findings provide reassurance and support continued expansion of DCD heart utilization in the United States.
