The potential of donation after circulatory death heart transplantations in the Netherlands

S. Roest, N.P. van der Kaaij, K. Damman, L.W. van Laake, J.A. Bekkers, M.E. Erasmus, O.C. Manintveld

Wednesday 13 march 2019

16:40 - 16:50h at Tropentheater

Categories: Best abstracts, Parallelsessie

Parallel session: Parallelsessie VIII – Best abstracts II

Background: The number of patients on the waiting list for a heart transplant is still rising while the number of transplantations is decreasing. Currently, only donation after brain death (DBD) is performed in heart transplantation. However, in England and Australia the first centers have started accepting hearts from donation after circulatory death (DCD) with excellent results. This represents a new pool of donors. Cardiac screening in DCD procedures is not performed in the Netherlands. In this study, the potential of DCD heart donors in the Netherlands was investigated with the data supplied by the “Nederlandse Transplantatie Stichting”.

Methods: We retrospectively reviewed all DCD procedures in the Netherlands from January 2013 until December 2017 and applied the in- and exclusion criteria from England and Australia; age, DCD class III, medical history (excluding cardiac disease, hepatitis B/C, etc.) and level of inotropic/vasopressor drugs.

Results: In these 5 years, 1006 DCD donors used for transplantation were identified. Of these, 319 donors were ≤50 years. After applying DCD exclusion criteria, 112 potential DCD heart donors remained. When the age limit was extended to ≤57 years, the number of potential DCD heart donors increased to 201. In comparison, in the same period 215 patients underwent a DBD heart transplant in the Netherlands.

Conclusions: DCD heart transplantation has a great potential in the Netherlands to decrease the time on the waiting list and reduce waiting list mortality. Cardiac screening in DCD procedures should become standard care to facilitate the potential of DCD heart transplantation.