Donation After Circulatory Death: Expanding Heart Transplants

J Cardiothorac Vasc Anesth. 2022 Oct;36(10):3867-3876. doi: 10.1053/j.jvca.2022.05.025. Epub 2022 May 23.

Abstract

Heart failure affects 6.2 million adults in the United States (US), resulting in a decrease in quality of life. Limited options exist for the treatment of end-stage heart failure. Mechanical circulatory support and transplantation are considered when no further optimization can be obtained with medical management. Heart transplant is regarded as superior to mechanical assist devices due to a lower incidence of multiorgan dysfunction. However, transplants are limited by the availability of donor organs. Heart transplants using organs from donation after circulatory death (DCD) have blossomed globally since 2014; whereas, in the US, this method has had a slower implementation. Today, the realization of the need to increase the number of donor hearts has reinvigorated the interest in heart transplantation using DCD organs. The authors review the process and discuss the unique opportunities anesthesiologists have to impact the future success of DCD heart transplantation as it continues to expand.

Keywords: DCD; cardiac anesthesiologist, normothermic regional perfusion; donation after circulatory death; ex vivo perfusion machine; heart transplant.

Publication types

  • Review

MeSH terms

  • Adult
  • Heart
  • Heart Failure* / surgery
  • Heart Transplantation* / methods
  • Humans
  • Perfusion / methods
  • Quality of Life
  • Tissue Donors
  • Tissue and Organ Procurement*