The Impact of Utilizing DCD Donor Hearts on Heart Transplant Activity and Waitlist Time

Abstract

<h3>Purpose</h3> Machine perfusion of donated organs after declaration of circulatory death (DCD) allows for the use of hearts previously discarded as not usable for transplantation. This opportunity potentially expands the donor pool and decreases waitlist time. This study aims to examine the impact of utilizing DCD hearts on heart transplant waitlist time <h3>Methods</h3> We retrospectively analyzed 161 patients who were listed for heart transplant from September 2019 through September 2021 at our center. These patients were separated into 2 periods centered on September 12, 2020 when transplantation of DCD donor hearts began <h3>Results</h3> Baseline patient characteristics were similar between both periods. In Period 1, 76 patients were waitlisted with 70 transplants occurring during this period, whereas in Period 2, 85 patients were waitlisted with 88 transplants occurring in this period. Thirty DCD donor heart transplants were performed in Period 2 (34% of period 2 transplants).Year over year transplant activity increased by 25.7%. Transplant rate increased from 2.06 person-year in Period 1 to 3.1 person-year in Period 2.There was no significant difference between the two periods with respect to waitlist mortality rate, length of post-transplant hospital stay, and short-term post-transplant survival. Median waiting time from listing to transplant was 17 days in Period 1 and 27 days in Period 2.There was no difference in blood types and United Network for Organ Sharing (UNOS) listing status between Period 1 and Period 2. <h3>Conclusion</h3> Our single-center analysis demonstrates that utilization of DCD donor hearts has resulted in an increase in transplant rate. Further extended follow-up is needed to determine long-term safety and efficacy of this strategy.