Results of Heart Transplantation from Donation After Circulatory Death (DCD) Donors Using Thoraco-Abdominal Normothermic Regional Perfusion (TA-NRP) Compared to Donation from Donation After Brain Death (DBD) Are Similar at One Year
1New York University Langone Medical Center, New York, NY, 2NYU Langone Health, New York, NY, 3New York University Langone Health, New York, NY
Meeting: 2022 American Transplant Congress
Abstract number: 196
Keywords: Donation, Heart, Outcome
Topic: Clinical Science » Heart » 63 - Heart and VADs: All Topics
Session Information
Session Time: 8:10am-9:15am
Presentation Time: 8:45am-9:00am
Location: Hynes Veterans Auditorium
*Purpose: In the U.S., interest in heart transplantation organ donation from DCD is increasing. Several different approaches are being considered. We present our institutional experience for recipients transplanted from DCD donors by using a TA-NRP protocol and compare the results to a cohort transplanted concomitantly from standard deceased after brain death (DBD) donation.
*Methods: For TA-NRP protocol, suitable local DCD donors were transferred to our institution and co-located with the recipient in proximate operating rooms. Standard DCD procurement involved resuscitation of the donor on cardiopulmonary bypass after declaration of death and assessment for suitability by echocardiogram and in-dwelling swan catheter. Heart transplant from DBD was performed per standard protocol. Immunosuppression and management followed the same standardized protocol for all recipients.
*Results: Between January 2020 and October 2021, we performed 10 DCD transplantations with TA-NRP protocol (7 isolated heart, 2 combined heart-lung and 1 combined heart-kidney). The median age was 54 years (range: 44-72 years), 70% male. One heart-bilateral lung transplant recipient required VA ECMO post-op for 3 days. During the same period, 70 patients received heart transplant from a DBD donor (50 [71.4%] isolated heart, 15 [21.4%] combined heart-lung, 5 [7.1%] combined heart-kidney). The median age was 56 years (range: 24-77) (p=0.916), 84.1% male (p=0.266). At mean follow-up of 397.6 days (DCD recipients) and 305.9 days (DBD recipients), there were no significant differences in acute cellular or antibody mediated rejection, cardiac allograft vasculopathy, heart graft function, or survival. Compared to DBD recipients, DCD recipients received transplant at lower listed statuses.
| UNOS Listing Status | # of DCD recipients | # of DBD recipients |
| 6 | 1 | – |
| 5 | 2 | 2 |
| 4 | 6 | 5 |
| 3 | 1 | 10 |
| 2 | – | 49 |
| 1 | – | 4 |
*Conclusions: Short-term results suggest that transplant outcomes from DCD TA-NRP are comparable to recipients from DBD. Expanding heart transplantation by using DCD is a viable option for lower-status listed patients and wide adoption should be considered.
To cite this abstract in AMA style:
Gidea C, James L, Smith DE, Carillo J, Reyentovich A, Saraon T, Katz S, Rao S, Goldberg R, Kadosh B, DiVita M, Cruz J, Sikand N, Ngai J, Piper G, Moazami N. Results of Heart Transplantation from Donation After Circulatory Death (DCD) Donors Using Thoraco-Abdominal Normothermic Regional Perfusion (TA-NRP) Compared to Donation from Donation After Brain Death (DBD) Are Similar at One Year [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/results-of-heart-transplantation-from-donation-after-circulatory-death-dcd-donors-using-thoraco-abdominal-normothermic-regional-perfusion-ta-nrp-compared-to-donation-from-donation-after-brain-deat/. Accessed December 3, 2024.« Back to 2022 American Transplant Congress