WASHINGTON  —New research from Duke Health reveals that a previously overlooked method of organ donation, called donation after circulatory death, could significantly increase the number of available hearts for transplantation. Traditionally, transplanted hearts are obtained from brain-dead donors, but this study shows that using hearts from circulatory death donors could provide a lifeline to thousands more patients in need.

The researchers suggest that adopting this approach could potentially expand the pool of donor hearts by 30%, and they advocate for it to become the standard practice in organ transplantation. Typically, organ donation occurs when individuals are determined to have no brain function after a severe injury, and their bodies are kept on ventilators to maintain heart function until the organs are recovered and preserved on ice.

Donation after circulatory death (DCD) involves a different process compared to traditional organ donation. In DCD, the decision to withdraw life support is made by the family when the patient has a severe brain injury but still has some remaining brain function. As a result, the heart eventually stops beating. Previously, surgeons hesitated to use these hearts due to concerns about potential damage during the period when organs were deprived of oxygen.

However, advancements have been made in the field. Surgeons can now place these DCD hearts into a machine that provides blood and nutrients, essentially reviving them and testing their functionality before transplantation. In a study involving 180 transplant recipients, half received DCD hearts while the other half received hearts from brain-dead donors transported on ice.

The research, conducted at multiple hospitals, revealed that the six-month survival rates were similar for both groups—94% for DCD heart recipients and 90% for those who received traditional hearts. This study was published in the New England Journal of Medicine.

The recent study on donation after circulatory death (DCD) heart transplants has sparked excitement among experts, offering the potential to increase fairness and accessibility in heart transplantation. With a record number of heart transplants performed in the U.S. last year, the study demonstrates that using DCD hearts can help address the significant demand for transplants.

However, there is still more to learn about this method, including refining the selection process and addressing the needs of the sickest patients on the waiting list. The study was funded by TransMedics, the manufacturer of the heart storage system used in the research.