Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec;26(12):1499-1507.
doi: 10.1007/s11886-024-02148-w. Epub 2024 Oct 9.

The Rapidly Evolving Landscape of DCD Heart Transplantation

Yashutosh Joshi  1   2   3 , Katherine Wang  4 , Campbell MacLean  4 , Jeanette Villanueva  5   4 , Ling Gao  5 , Alasdair Watson  6 , Arjun Iyer  6 , Mark Connellan  6 , Emily Granger  6 , Paul Jansz  6 , Peter Macdonald  6   5   4
Affiliations
Review

The Rapidly Evolving Landscape of DCD Heart Transplantation

Yashutosh Joshi et al. Curr Cardiol Rep. 2024 Dec.

Abstract

Purpose of review: To summarise current international clinical outcomes from donation after circulatory death heart transplantation (DCD-HT); discuss procurement strategies, their impact on outcomes and overall organ procurement; and identify novel approaches and future areas for research in DCD-HT.

Recent findings: Globally, DCD-HT survival outcomes (regardless of procurement strategy) are comparable to heart transplantation from brain dead donors (BDD). Experience with normothermic machine perfusion sees improvement in rates of primary graft dysfunction. Techniques have evolved to reduce cold ischaemic exposure to directly procured DCD hearts, though controlled periods of cold ischaemia can likely be tolerated. There is interest in hypothermic machine perfusion (HMP) for directly procured DCD hearts, with promising early results. Survival outcomes are firmly established to be equivalent between BDD and DCD-HT. Procurement strategy (direct procurement vs. regional perfusion) remains a source of debate. Methods to improve allograft warm ischaemic tolerance are of interest and will be key to the uptake of HMP for directly procured DCD hearts.

Keywords: Donation after circulatory death; Heart transplantation; Hypothermic machine perfusion; Normothermic machine perfusion; Normothermic regional perfusion.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing Interests: PM reports grants from National Health and Medical Research Foundation, grants from Medical Research Future Fund, grants and personal fees from Novartis, personal fees from Boehringer Ingleheim, personal fees from Astra-Zeneca, non-financial support from Indian Society for Heart and Lung Transplantation, non-financial support from Congress of the Asian Society of Transplantation, other from Infensa, other from Transmedics, outside the submitted work. Human and Animal Rights and Informed Consent: No animal or human subjects by the authors were used in this study.

Figures

Fig. 1
Fig. 1
Retrieval timeline for directly procured donation after circulatory death donor hearts
See this image and copyright information in PMC

References

    1. Joshi Y, Scheuer S, Chew H, Ru Qiu M, Soto C, Villanueva J, et al. Heart Transplantation from DCD donors in Australia: lessons learned from the first 74 cases. Transplantation. 2022. 10.1097/TP.0000000000004294. - DOI - PubMed
    1. Messer S, Rushton S, Simmonds L, Macklam D, Husain M, Jothidasan A, et al. A national pilot of donation after circulatory death (DCD) heart transplantation within the United Kingdom. J Heart Lung Transpl. 2023;42(8):1120–30. 10.1016/j.healun.2023.03.006. - DOI - PubMed
    1. Miñambres E, Royo-Villanova M, Pérez-Redondo M, Coll E, Villar-García S, Canovas SJ, et al. Spanish experience with heart transplants from controlled donation after the circulatory determination of death using thoraco-abdominal normothermic regional perfusion and cold storage. Am J Transpl. 2021;21(4):1597–602. 10.1111/ajt.16446. - DOI - PubMed
    1. Schroder JN, Patel CB, DeVore AD, Bryner BS, Casalinova S, Shah A, et al. Transplantation outcomes with Donor hearts after Circulatory Death. N Engl J Med. 2023;388(23):2121–31. 10.1056/NEJMoa2212438. - DOI - PubMed
    1. Joshi Y, Villanueva J, Gao L, Hwang B, Zhao C, Doyle A, et al. Donation after circulatory death: a New Frontier. Curr Cardiol Rep. 2022. 10.1007/s11886-022-01798-y. - DOI - PMC - PubMed