Normothermic regional perfusion in donation after circulatory death compared with brain dead donors: Single-center cardiac allograft outcomes.

Objective: We sought to provide a single-center analysis of our normothermic regional perfusion (NRP)-recovered donation after circulatory death (DCD) heart transplant outcomes compared with a historical control group of donors of donation after brain death (DBD). We hypothesized that postoperative short-term outcomes and long-term survival trends are comparable in DCD-NRP and DBD cardiac allografts.

Methods: All adult heart-only transplants performed at our institution between January 2020 and June 2024 were retrospectively reviewed. Recipients were stratified into 2 groups: DCD-NRP and DBD. Propensity score matching was used to compare postoperative short and long-term outcomes. Kaplan-Meier was used to evaluate survival.

Results: Four hundred fifteen recipients met the inclusion criteria: 275 (63%) in the DBD group and 140 (37%) in the DCD-NRP group. In the propensity score-matching model there were no differences in severe primary graft dysfunction, mechanical circulatory support, right heart dysfunction, vasoactive inotropic scores, and 30-day mortality. There was also no difference in 1- and 3-year survival between groups.

Conclusions: In our single-center study, we found no differences in short and long-term outcomes between cardiac allografts from NRP-DCD compared with DBD donors. As such, NRP-recovered donors may be considered equivalent in terms of recipient outcomes to DBD donors.