Heart Transplantation from Donation after Circulatory Determined Death: The Royal Papworth Experience.

PURPOSE: Heart transplantation from donors following circulatory determined death (DCD) has seen an increase in adoption in Europe in the last year. Early outcomes previously reported by our group were comparable to concurrent heart transplantation from donation after brain death. We initially limited the use of DCD hearts to lower risk recipients. With increasing experience, we have extended the use of DCD hearts on all comers. Here we provide an updated report on the outcomes to include our 70th DCD heart transplant.

METHODS: All patients who underwent a DCD heart transplant at Royal Papworth from March 2015 to September 2019 are included and analysed as two cohorts to compare our first sequential 35 against the next 35 DCD heart transplants. Consent for organ donation was obtained from the next-of-kin of Maastricht III DCD donors aged between 18-57 years. All donors had satisfactory pre-withdrawal echocardiography and had a functional warm ischaemic time of up to 30minutes.

RESULTS: The results are highlighted in Table 1, the recipient profile in cohort 2 was found to be significantly higher in TPG.

CONCLUSION: DCD heart transplantation continues to show promising results despite being carried out in more recipients with higher PVR. This valuable resource can be of benefit to the majority of patients on the heart transplant waiting list. At our centre, DCD heart transplantation has now become routine practice.