Dilemmas concerning heart procurement in controlled donation after circulatory death

S E Kaffka Genaamd Dengler; M T Vervoorn; M Brouwer; J de Jonge; N P van der Kaaij

doi:10.3389/fcvm.2023.1225543

Dilemmas concerning heart procurement in controlled donation after circulatory death

Front Cardiovasc Med. 2023 Jul 31:10:1225543. doi: 10.3389/fcvm.2023.1225543. eCollection 2023.

Authors

S E Kaffka Genaamd Dengler¹, M T Vervoorn¹, M Brouwer¹, J de Jonge², N P van der Kaaij¹

Affiliations

¹ Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
² Department of Surgery, Erasmus Medical Center Transplant Institute, Rotterdam, Netherlands.

Abstract

With an expanding population at risk for heart failure and the resulting increase in patients admitted to the waiting list for heart transplantation, the demand of viable organs exceeds the supply of suitable donor hearts. Use of hearts after circulatory death has reduced this deficit. Two primary techniques for heart procurement in circulatory death donors have been described: direct procurement and perfusion and thoraco-abdominal normothermic regional perfusion. While the former has been accepted as an option for heart procurement in circulatory death donors, the latter technique has raised some ethical questions in relation to the dead donor rule. In this paper we discuss the current dilemmas regarding these heart procurement protocols in circulatory death donors.

Keywords: controlled donation after circulatory death heart transplantation; determination of death; ethics; ex-situ heart perfusion; thoracoabdominal normothermic regional perfusion.

Publication types

Review