title: Heart transplantation with donation after circulatory determination of death.
abstract: The constant shortage of available organs is a major obstacle and limiting factor in heart transplantation; the discrepancy between the number of donors and potential recipients leads to waiting-list mortality of 10-12% per year in Europe and the USA. If adopted for heart transplantation, donation after circulatory determination of death (DCDD) would be expected to improve the availability of organs substantially for both adults and children. With DCDD, however, hearts to be transplanted undergo a period of warm ischaemia before procurement, which is of particular concern because tissue damage occurs rapidly and might be sufficient to preclude transplantation. Nonetheless, the heart is able to withstand limited periods of warm ischaemia, which could provide a window of opportunity for DCDD. Development of clinical approaches specifically for DCDD is critical for the exploitation of these organs, because current practices for donor heart procurement, evaluation, and storage have been optimized for conventional donation after brain death, without consideration of warm ischaemia before organ procurement. Establishment of clinical protocols and ethical and legal frameworks for DCDD of other organs is underway. This Review provides a timely evaluation of the potential for DCDD in heart transplantation.
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Longnus
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Veronika
authors.initials: V
authors.lastname: Mathys
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Monika
authors.initials: M
authors.lastname: Dornbierer
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Dick
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Thierry P
authors.initials: TP
authors.lastname: Carrel
authors.affiliation: Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Murtenstrasse 35, CH-0310, Switzerland.
authors.forename: Hendrik T
authors.initials: HT
authors.lastname: Tevaearai
mesh_terms: D001926:Brain Death; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D009927:Tissue and Organ Procurement / Q000379:methods*
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