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Advances in the field of ex vivo perfusion may result in machine perfusion devices becoming more affordable and the new standard of care for transport of organs for heart transplantation. Countries must decide whether NRP is ethically and legally acceptable. Finally, the argument to expand DCD heart transplantation would be strengthened by pragmatic randomized controlled trials that provide evidence of efficacy and cost-effectiveness across different healthcare systems. DBD indicates donation after brain stem—determined death; and DCD, donation after circulatory-determined death.

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The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association. Home Circulation: Heart Failure Vol. View PDF. Tools Add to favorites Download citations Track citations Permissions. Jump to. Pettit Stephen J. Mark C. Petrie Mark C. See Article by Ribeiro et al Heart transplantation is an excellent treatment for carefully selected patients with advanced heart failure. Advantages and Disadvantages of DBD and DCD Heart Transplantation DBD DCD Advantages Detailed assessment and optimization of heart function before retrieval Extended pool of potential donors Short period of warm ischemia Heart not subjected to catecholamine surge before retrieval Well established treatment with excellent long-term outcomes Good short-term outcomes in limited experience to date Disadvantages Heart subjected to catecholamine surge at time of brain death Potential donor may not meet circulatory death criteria after withdrawal of support Limited pool of potential donors Longer period of warm ischemia Challenging to assess heart function, particularly with direct procurement and perfusion Ethical concerns about normothermic regional perfusion in some countries Cost of machine perfusion device Long-term outcomes uncertain DBD indicates donation after brain stem—determined death; and DCD, donation after circulatory-determined death.

Email stephen. References 1. The international thoracic organ transplant registry of the international society for heart and lung transplantation: thirty-fifth adult heart transplantation report; focus theme: multiorgan transplantation. J Heart Lung Transplant. National Data. Organ Procurement and Transplantation Network. Accessed February 20, Google Scholar 3. NHS Blood and Transplant. Organ Donation and Transplantation.

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Google Scholar 4. Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series. Functional assessment and transplantation of the donor heart after circulatory death.

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Hearts donated after circulatory death and reconditioned using normothermic regional perfusion can be successfully transplanted following an extended period of static storage. More quotes Did you know More interesting things.. About the Wiki. Eleven sister Wikis in Other Languages. The French wiki La Garde de Nuit. Links to articles that are available in other languages are accessed via the globe icon.

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