ArticleJTCVS open2024
Donor heart refusal after circulatory death: An analysis of United Network for Organ Sharing refusal codes.
Article in JTCVS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Optimal coronary flow rates for preservation of function during normothermic ex situ heart perfusion.The Journal of thoracic and cardiovascular surgery · 2026Article
- Expanding Use of Donation After Circulatory Death Heart Transplantation to Higher Acuity Recipients.The Annals of thoracic surgery · 2026Article
- A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death.Journal of visualized experiments : JoVE · 2025Article
- Reducing mitochondrial dysfunction through combination therapy to limit ischemia-reperfusion injury in male DCD rats.Frontiers in cardiovascular medicine · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Objective: Donor hearts procured after circulatory death (DCD) may significantly increase the number of hearts available for transplantation. The purpose of this study was to analyze current DCD and brain-dead donor (DBD) heart transplantation rates and characterize organ refusal using the most up-to-date United Network for Organ Sharing (UNOS) and Organ Procurement and Transplantation Network data. Methods: We analyzed UNOS and Organ Procurement and Transplantation Network DBD and DCD candidate, transplantation, and demographic data from 2020 through 2022 and 2022 refusal code data to characterize DCD heart use and refusal. Subanalyses were performed to characterize DCD donor demographics and regional transplantation rate variance. Results: DCD hearts were declined 3.37 times more often than DBD hearts. The most frequently used code for DCD refusal was neurologic function, related to concerns of a prolonged dying process and organ preservation. In 2022, 92% (1329/1452) of all DCD refusals were attributed to neurologic function. When compared with DBD, DCD donor hearts were more frequently declined as the result of prolonged warm ischemic time (odds ratio, 5.65; 95% confidence interval, 4.07-7.86) and other concerns over organ preservation (odds ratio, 4.06; 95% confidence interval, 3.33-4.94). Transplantation rate variation was observed between demographic groups and UNOS regions. DCD transplantation rates are currently experiencing second order polynomial growth. Conclusions: DCD donor hearts are declined more frequently than DBD. DCD heart refusals result from concerns over a prolonged dying process and organ preservation. Heart transplantation rates may be substantially improved by ex situ hemodynamic assessment, adoption of normothermic regional perfusion guidelines, and quality initiatives.
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Registered trials
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