Impact of Donation After Circulatory Death Heart Transplantation on Waitlist Outcomes and Transplantation Activity

Abstract

<h3>Purpose</h3> To assess the impact of increased availability of donor hearts from donors after circulatory death on waiting list and heart transplantation activity. <h3>Methods</h3> We compared changes in waitlist activity and transplant volumes in patients before and after we adopted DCD heart transplantation into our program. Outcomes of patients who were on the waiting list between January and August 2020 (Period 1) were compared to those listed between January and August 2021 (Period 2). <h3>Results</h3> Waitlist volumes were 10.6 patients listed per month in Period 1 (N = 85) and 7.5 patients in Period 2 (N = 60). The median waitlist time to transplant decreased from 339 days in Period 1 to 77 days in Period 2 (<i>P</i> = .035). The transplant rate increased from 92 per 100 patient-years in Period 1 to 186 per 100 patient-years in Period 2 (<i>P</i> = .004). No status 5 and 6 recipients were transplanted in Period 1 as opposed to 13% in Period 2 (Figure 1). Waitlist mortality rate, hospital stay post-transplantation, and post-transplant mortality did not differ significantly between the time periods. <h3>Conclusion</h3> This single-center retrospective analysis suggests that the use of DCD donor hearts may result in a reduced HTx waitlist time and an increased transplant rate. DCD increases organ availability to recipients in lowers status categories. In addition, transplanting DCD donor hearts can provide comparable short-term post-transplant outcomes to DBD. Figure 1. Transplant activity stratified by recipient status.