JAMA ( IF 45.540 ) Pub Date : 2020-01-14 , DOI: 10.1001/jama.2019.21073 Jennifer Abbasi
An adult patient received a “donation after circulatory death” (DCD) heart transplant in the first such procedure to take place in the United States. Surgeons at Duke University Hospital in Durham, North Carolina, recently performed the operation as part of a clinical trial evaluating the Organ Care System (OCS) Heart, an investigational normothermic preservation system from Massachusetts-based TransMedics. An alternative to cold storage, the device keeps the donor heart pumping with warm oxygen- and nutrient-rich blood.
The first heart transplants were DCD procedures, but the field has since shifted to donation after brain death (DBD). Bringing back routine use of DCD could expand the donor heart pool by an estimated 30%, improving the chances of survival for the approximately 250 000 US patients with end-stage heart failure, Jacob N. Schroder, MD, surgical director of Duke’s heart transplant program, said in an email.
Surgeons have recently started to transplant more DCD lungs, livers, and kidneys. But the heart has a lower tolerance for warm ischemia time (WIT), the period after circulation stops and before the organ is perfused with a cold preservation solution.