New Technique Could Expand Donor Pool for Pediatric Heart Transplants by Up to 20%

Duke Health has reported that a new technique could expand “by up to 20% the donor pool for pediatric heart transplants in the U.S.”

The new approach is meant to “overcome barriers to heart donation after circulatory death in infants.” The technique is called DCD and it allows for “heart donation to take place after a circulatory death, rather than brain death (once the standard in donation), as long as the functionality of the heart can be assessed on a perfusion device. DCD has previously been used in adult and adolescent transplants, but existing perfusion devices are too large to fit infant hearts.”

A technique called “normothermic regional perfusion (NRP) could reanimate the heart inside of the body, but it carries logistical and ethical barriers. … The lack of NRP uptake causes viable pediatric donor hearts to go unused.” The Duke team developed a technique that “temporarily reanimates the donor heart outside of the body on a surgical table using a heart-lung machine (extracorporeal membrane oxygenation or ECMO) – allowing surgeons to assess the organ’s viability before transplant. The approach avoids the barriers associated with NRP and could become a new standard of care.”

The first-of-its-kind case “saved the life of a then 3-month-old patient, who received the procedure earlier this year.” About 700 children are added to the pediatric heart transplant waitlist in the U.S. each year, and 10-20% die while waiting on the list.”