Breaking barriers in cardiac donation after circulatory death.
Background: Heart transplant from controlled donation after
circulatory death (cDCD) is an emerging strategy that is rapidly
expanding and may help increase the heart donor pool. Materials
and Methods: The use of thoracoabdominal normothermic regional
perfusion (TANRP) with extracorporeal membrane oxygenation device has
allowed to perform cardiac transplantation after cDCD. Several
experiences have been carried out in recent years, however the maximum
cold ischemia time is still unknown. We present a successful case of
heart transplantation using a graft from cDCD from another hospital with
201 minutes of cold ischemia time, the longest published in Europe.
Discussion and conclusion: Heart transplant from cDCD could be
a good alternative to brain dead donation. This experience suggests than
nonlocal cardiac donation in controlled asystole could tolerate long
periods of cold ischemia time and break the main barriers in cardiac
donation after circulatory death.