The organ gap in NYS and the nation continues to grow, as does the number of donation after circulatory death (DCD) donors. However, hearts procured from DCD donors are not used due to the ischemic injury the heart sustains during reperfusion. On the one hand, CMS has encouraged the organ donation community to pursue all DCD opportunities yet the performance measures for transplant centers make the use of innovative transplant techniques difficult to implement.
Over the past several years, the use of DCD hearts in Australia and the UK and the overall good outcomes being reported, has caught the interest of the US heart transplant community and is a way to increase the number of available hearts for transplant in NYS. NYCTC conducted a feasibility study to review best practices from international heart transplant centers where they have successfully used DCD donor hearts in transplantation. A literature review was conducted and available data indicated a sufficient number of DCD donors to significantly increase the number of transplants.
A feasibility study was conducted and approved by the NYCTC Board of Directors in December 2017 and shared with DOH in early 2018. The membership pointed out the main obstacle to the pursuit of DCD transplantation is delays in federal approval for the preservation device, although approval was anticipated to occur in 2018 it is still currently pending.
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