Early Results Using Donation After Circulatory Death (DCD) Donor Hearts

Donation after circulatory death (DCD) has contributed significantly to kidney, lung and liver transplant activities over the last decade. With an ever increasing demand for cardiac transplantation and worsening shortages of donor hearts, there has been growing interests in transplanting hearts from DCD donors. This was initially made possible by co-locating the donor and recipient to ensure the shortest possible ischaemic time for the DCD heart. More recently, reconditioning and distant procurement of arrested DCD hearts has been achieved by using machine perfusion. Early outcomes have been very encouraging, and experience to date suggests that DCD donors can contribute significantly to the number of donor hearts available for transplantation. There are variations in the legal and ethical frameworks between countries with regard to DCD organ donation and transplant teams must work within their respective local guidelines. We review the current status of clinical DCD heart transplantation and appraise the merits of the various approaches. © 2016, Springer International Publishing AG.