Concerns about the viability of DCD hearts stem from the period of oxygen deprivation before recovery, which can compromise organ quality.

Traditional DCD recovery methods, such as normothermic regional perfusion (NRP), are controversial and banned in some hospitals due to their complexity and use of specialized machinery.

Vanderbilt’s Dr. Aaron M. Williams emphasizes that DCD hearts perform comparably to those from brain-dead donors, supporting their increased use.

Emerging techniques focus on simpler, less controversial recovery methods that do not rely on expensive machinery, making them more practical for small hearts needed by young patients.

In 2024, 43% of deceased organ donors in the U.S. died via circulatory death, yet only 793 of 4,572 heart transplants used these donors, highlighting the need for improved recovery methods.

Researchers at Duke and Vanderbilt are developing new techniques to increase the availability of hearts for transplant, especially from donors who experience circulatory death (DCD).

At Duke, surgeons successfully transplanted a heart into a 3-month-old infant using a novel method that involved briefly assessing the heart's function on a sterile table after removal.

Vanderbilt employs a simpler preservation technique by infusing the heart with a nutrient-rich solution before removal, aiding in transport and viability.

Traditionally, most heart donations come from brain-dead donors, with organs maintained on ventilators until recovery.

DCD involves recovering organs after a patient’s heart stops due to withdrawal of life support, but this process presents challenges in ensuring organ quality due to oxygen deprivation.

While nearly half of deceased donors are from circulatory death, only a small fraction of heart transplants utilize these organs, underscoring a significant organ shortage.

The demand for transplantable hearts is urgent, with hundreds of thousands of adults suffering from heart failure and about 700 children added annually to the transplant list, of whom 20% die waiting.