The Donor Heart After Withdrawal of Life Support

The biggest problem in heart transplantation is the shortage of donor hearts. This shortage results in the death of significant numbers of patients with end-stage heart failure who would have been eligible to receive a new heart. To boost the number of hearts available for transplantation, researchers have been investigating alternative pathways for heart donation. One solution that has significantly increased the number of organs available for lung, liver, and kidney transplantation is referred to as donation after circulatory death (DCD). The biggest problem with DCD hearts is that they are injured because of the donation process and we still can’t precisely identify which heart would be safe or unsafe for recipients. Addressing this problem would remove a major barrier to the use of DCD hearts for transplantation, and reduce the number of people dying unnecessarily on transplant waiting lists.

The main objective of this proposal is to study human DCD hearts on a machine, to find ways of identifying when a heart is too injured, and therefore unsafe to use for a recipient. This approach would allow surgeons to make
decisions about a heart’s suitability before committing a recipient to a heart with an uncertain outcome. In most of the world (including British Columbia), DCD hearts are not currently used for transplantation. In fact, these
hearts are simply discarded. This represents a lost opportunity for researchers who could put the heart to good use, and make valuable discoveries that would benefit heart failure patients and society.