Comparing Mid-Term Outcomes of Donation After Brain Death and Donation After Circulatory Death Orthotopic Heart Transplant Recipients–A Single-Center Retrospective UK Study

Abstract

Introduction

The number of patients on heart transplant waitlists is growing globally, with an insufficient number of organ offers to meet this growing demand. To help improve patient outcomes, in the United Kingdom (UK), orthotopic cardiac transplantation (OCTx) can occur using hearts donated following donor brain death (DBD) or donor circulatory death (DCD). The aim of this paper was to compare outcomes between groups of DBD and DCD OCTx patients at Harefield Hospital.

Methods

44 DCD patients (transplanted between 2012 and 2023) were matched (with outcomes blinded, by age and gender) with 33 DBD patients (transplanted between 2015 and 2023). Short-term outcomes (up until 1-year posttransplants, including outcomes such as primary graft dysfunction [PGD] and length of intensive care unit [ICU] stay) and midterm outcomes (up until 5 years posttransplant, including outcomes such as all-cause-mortality, episodes of rejection and graft left ventricular function) were assessed.

Results

Overall, no significant differences were noted with regard to baseline characteristics, and outcome measures (both short and mid-term outcomes) between the matched DCD and DBD cohorts. Event-free survival with regard to all-cause mortality also remained not significantly different between both groups (log-rank p < 0.756).

Conclusion

In conclusion, our single-center UK data did not demonstrate any differences in outcomes between DCD and DBD OCTx patients. We add to growing literature that would support DCD organ use in heart transplantation, in an effort to reduce growing organ demand worldwide.