DCD donor hearts could help ease organ shortages

Experts at Massachusetts General Hospital have successfully performed five CV transplants using Donation after Circulatory Death (DCD) donor hearts—the largest number of adult DCD heart transplants ever completed in the U.S.

MGH announced the news Jan. 10, noting the first adult DCD heart transplant performed in the country took place at Duke University Hospital last month. Duke and MGH are two of five centers taking part in a clinical trial of DCD heart transplants.

DCD donors aren’t necessarily typical organ donors—they demonstrate brain function that’s incompatible with life but doesn’t meet all criteria for brain death. Heart transplants have historically been dependent on organs donated after brain death or irreversible loss of brain function, so DCD donors represent an entire subset of patients whose hearts could be repurposed.

In the case of a DCD donation, a patient is removed from life support and, if their heart stops beating within a certain period of time, they’re declared dead and their heart is removed from their body. Physicians at MGH would then use a portable Organ Care System (OCS)—often called a “heart in a box”—to restore the donor heart with warm, oxygenated blood until it’s ready to be transplanted. The OCS, which was designed by Massachusetts medical tech company Transmedics, was used during the world’s first DCD heart transplant in Australia in 2014 and in England’s first DCD heart transplant in 2015.

“This is a significant moment not only for MGH, but hopefully for transplant centers around the country,” David D’Alessandro, MD, surgical director for heart transplantation at MGH, said in a statement. “Patients die each day while waiting for transplants due to a major shortage of suitable organs. This is one way we can work toward addressing that gap.”

The DCD heart transplant trial is slated to run through August of 2021.