TY - JOUR
T1 - Potential for donation after circulatory death heart transplantation in the United States
T2 - Retrospective analysis of a limited UNOS dataset
AU - Farr, Maryjane
AU - Truby, Lauren K.
AU - Lindower, Joel
AU - Jorde, Ulrich
AU - Taylor, Samantha
AU - Chen, Leway
AU - Gass, Alan
AU - Stevens, Gerin
AU - Reyentovich, Alex
AU - Mancini, Donna
AU - Arcasoy, Selim
AU - Delair, Samantha
AU - Pinney, Sean
N1 - Publisher Copyright:
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Donation after Circulatory Death (DCD) is an alternative to Donation after Brain death (DBD), and is a growing strategy for organ procurement in the United States(US). The purpose of this analysis was to review the number and quality of hearts in one United Network for Organ Sharing (UNOS) Region that were not utilized as a potential consequence of nonheart DCD donation. We retrospectively identified all successful US DCD solid organ donors from 1/2011 to 3/1/2017, defined an ideal heart donor by age and left ventricular ejection fraction (LVEF), and then reviewed the donor charts of unused hearts in New York and Vermont (UNOS Region 9). Of 8302 successful DCD donors across the United States, 5033 (61%) were between 18 and 49 years of age, and 872 had a screening echocardiogram, with 573 (66%) measuring an EF >50%. Of these 573 potential donors, 44 (7.7%) were from Region 9. Detailed donor chart review identified 36 ideal heart donors, 24 (66.7%) with anoxic brain injury. Trends in Region 9 DCD donation increased from 4 unused hearts in 2011, to 13 in 2016. In the context of severe organ scarcity, these data indicate that implementation of DCD heart transplantation in the United States would improve overall donation rates and provide a pathway to utilize these ideal donor hearts.
AB - Donation after Circulatory Death (DCD) is an alternative to Donation after Brain death (DBD), and is a growing strategy for organ procurement in the United States(US). The purpose of this analysis was to review the number and quality of hearts in one United Network for Organ Sharing (UNOS) Region that were not utilized as a potential consequence of nonheart DCD donation. We retrospectively identified all successful US DCD solid organ donors from 1/2011 to 3/1/2017, defined an ideal heart donor by age and left ventricular ejection fraction (LVEF), and then reviewed the donor charts of unused hearts in New York and Vermont (UNOS Region 9). Of 8302 successful DCD donors across the United States, 5033 (61%) were between 18 and 49 years of age, and 872 had a screening echocardiogram, with 573 (66%) measuring an EF >50%. Of these 573 potential donors, 44 (7.7%) were from Region 9. Detailed donor chart review identified 36 ideal heart donors, 24 (66.7%) with anoxic brain injury. Trends in Region 9 DCD donation increased from 4 unused hearts in 2011, to 13 in 2016. In the context of severe organ scarcity, these data indicate that implementation of DCD heart transplantation in the United States would improve overall donation rates and provide a pathway to utilize these ideal donor hearts.
KW - clinical research/practice
KW - donors and donation: donation after circulatory death (DCD)
KW - donors and donation: donor evaluation
KW - donors and donation: extended criteria
KW - ethics and public policy
KW - heart transplantation/cardiology
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U2 - 10.1111/ajt.15597
DO - 10.1111/ajt.15597
M3 - Article
C2 - 31529766
AN - SCOPUS:85074618201
SN - 1600-6135
VL - 20
SP - 525
EP - 529
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 2
ER -