P48: A Single Center Early Experience With DCD Heart Transplantation: Lessons Learned On A New Journey

Abstract

Intro Heart transplantation remains the gold standard for end stage heart failure refractory to medical therapies. Methods to expand the donor pool continue to highlight the need to increase the supply of hearts to meet the demand. We aim to describe our experience with DCD (donor cardiac death) heart transplantation. Methods: We obtained the total number of DCD attempts at our institution since enactment of our DCD program from our OPO administrator from February 1, 2022 through September, 30, 2022. Our OPO is through Donor Network of Arizona and serves communities across the Southwestern United States. Results: Out of the 11 DCD procurements, 3 hearts were successfully procured, 5 donors did not progress to circulatory death, and 3 donor hearts were turned down due to quality issues. Average age and sex of DCD donors that were used: 22 years, 2 male and 1 female, unused: 30 years, 5 male, and 3 female. Cause of death in the DCD donors that were used included head trauma (2) and anoxia (1). Cause of death in the DCD donors that were not used: head trauma (2), anoxia (5), CVA (1). For the organs that were turned down due to quality, 2 had significant coronary calcifications and 1 had a cardiac contusion. Forty-five percent of our DCD donors did not progress to donor circulatory death. We were able to successfully utilize 27% of DCD offers. Conclusion: More data are required for successful procurement of DCD hearts and further studies are needed to optimize resource utilization. Specifically, predictive models of which hearts are suitable quality and which donors will progress to circulatory death are needed.