The UK has the most successful DCD heart programme in the world which has primarily been developed in one region in England. Due to a combination of factors, the number of hearts available for transplant in the UK falls significantly short of demand, despite the expansion of the donor pool through widening the acceptance criteria. In order to balance the limited supply of donated hearts with the increasing demand an alternative approach needed to be explored. The implementation of the DCD heart programme has required a co-productive approach, utilising strong leadership skills in order to operationalise a conceptual transplantation programme. A key feature for success has been a multi-disciplinary collaboration between NHSBT and Papworth & Harefield hospitals. Despite initial reservations on ethical grounds and the financial implications, a clear vision and management plan was integral to the delivery of a world-leading programme.

Whilst the number of potential DBD donors in the UK remains static the Donation after Circulatory determined Death (DCD) programme continues to grow with significant additional potential identified. DCD donors account for a high percentage of the total deceased donor pool in theUKand in an attempt to increase organ supply, abdominal and lung transplant programmes have successfully utilised organs from DCD organ donors.

Teams at Papworth and Harefield Hospitals have been working to develop and implement a programme to facilitate heart donation from DCD donors. This programme has been actively supported by NHS Blood and Transplant and the specialist nurses in 3 organ donation services teams.

Specialist nurse teams were significantly involved over many years in the engagement with stakeholders in referring hospitals prior to the implementation of the programme in order to ensure they were completely aware and supportive of the procedures associated with DCD heart retrievals.

At this time, the DCD heart programme has been recognised as an unmitigated success and as such, is being extended to a third transplant centre in Manchester.

The ability to utilise hearts from this type of donor has introduced a new pool of heart donors in the UK. Training and raising awareness to support this innovative programme was successfully undertaken and positively put into practise in 3 geographical areas.

CITATION INFORMATION: Ryan M, Duncalf S. Implementing a Successful DCD Heart Programme to the United Kingdom. Am J Transplant. 2017;17 (suppl 3).

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