Heart transplant donation after circulatory death not inferior to donation after brain death

A recent study has found no significant differences in the outcomes among recipients of heart transplant donation after circulatory death (DCD) and those of heart donation after brain death (DBD).

This retrospective observational study was carried out involving all adult heart-only transplants in a single centre from January 2020 to January 2023 to compare 6-month and 1-year clinical outcomes between recipients of DCD hearts and those of DBD hearts.

The investigators abstracted the recipient and donor data from medical records and the United Network for Organ Sharing registry, respectively. They then compared outcomes between the two groups via survival analysis and Cox regression.

A total of 385 adults (median age 57.4 years) underwent heart-only transplantation during the study period, including 122 (32 percent) from DCD donors, of which 83 percent were recovered using normothermic regional perfusion (NRP).

DCD donors were younger and had fewer comorbidities than DBD donors. On the other hand, DCD recipients were less likely to be hospitalized prior to hospitalization or require pretransplantation temporary mechanical circulatory support relative to recipients of DBD hearts.

No significant between-group differences were observed in 1-year survival, incidence of severe primary graft dysfunction, treated rejection during the first year, or likelihood of cardiac allograft vasculopathy at 1-year post-transplantation.

“This study adds to the published data supporting DCD donors as a safe means to expand the heart donor pool,” the investigators said.