DCD Heart Trials: A Life-Saving Innovation
An emerging technique known as donation after circulatory death may help address the shortage of viable hearts for transplant.
In this country, more than 3,500 people are on the waiting list for a new heart. The majority are in their 50s and early 60s, and most have severe, debilitating heart failure. But because of a shortage of suitable donor hearts, fewer than half will receive a heart transplant. However, an emerging technique, known as donation after circulatory death, may help address that gap in coming years.
For decades, all heart transplants done in the United States have used hearts donated after brain death, which is defined as the irreversible loss of all brain function. Organs other than the heart — including lungs, kidneys, pancreas, and livers — are donated after either brain death or after circulatory death, a circumstance known as donation after circulatory death, or DCD.
Twenty-five heart transplant centers throughout the United States, are taking part in a clinical trial of DCD heart transplants.
What is DCD?
Historically, hearts and other organs used in transplants have come from people who experience a serious trauma, such as a car accident, gunshot wound, or massive stroke. In recent years, this has also included people resuscitated from opioid overdoses, whose brains have been without oxygen too long. If they have no detectable brain activity, they are considered brain dead. Those who are organ donors remain on a breathing machine while their organs are recovered.
Others in similar circumstances may not meet the strict criteria for brain death: they have a devastating brain injury with no chance of recovery but may still have some involuntary reflexes. If the person’s family decides to withdraw life sustaining measures, and the person’s heart stops beating within a certain window of time, death is declared. Donors may then have their organs removed, known as donation after circulatory death (also called donation after cardiac death or DCD). But hearts are particularly vulnerable to injury, so they don’t function reliably well after conventional DCD. The new Organ Care System helps solve that problem.
While it’s the actual transplant centers participating in the study, LifeSource, as the Organ Procurement Organization, worked with our participating local transplant centers to prepare with process check lists, staff training and resource guides.
Organ Care system- designed by the Massachusetts-based company TransMedics:
- Often referred to as “Heart-in-a-Box”, the OCS™ Heart is a revolutionary system that preserves donor organs.
- The OCS acts as a miniature intensive care unit that keeps organs alive and healthy by preserving them in a natural state that mimics the human body, so organs can remain viable for transplant along the way to recipients.
- OCS Heart is the only system used in DCD Heart transplantation worldwide.
- Hearts placed on the Organ Care System have been transplanted after as long as sixteen hours. With a traditional transplant, the recovered heart is chilled and unable to pump oxygenated blood, leaving it more prone to deterioration or damage. These hearts remain viable for only six hours.
Donors After Circulatory Death Heart Clinical Trial
- Study start date December 1, 2019
- DCD heart transplant trial is expected to continue through August 2021