The role of transesophageal echocardiography in guiding heart donation after circulatory death

Clin Transplant. 2022 Sep;36(9):e14783. doi: 10.1111/ctr.14783. Epub 2022 Aug 16.

Abstract

Heart donation after circulatory death (DCD) can significantly expand the heart donor pool, helping to overcome the problem of organ shortage and the increase in waiting list mortality and morbidity. To improve the outcome of DCD heart transplantation, thoraco-abdominal normothermic regional perfusion (TA-NRP) can be performed by selectively restoring circulation followed by in vivo functional heart assessment. Here, we report on the use of periprocedural transoesophageal echocardiography (TOE) as a minimally invasive cardiac assessment tool during different stages of a DCD heart procurement procedure using TA-NRP. We conclude that TOE is a valuable method to assess the donor heart for transplantation eligibility before and after withdrawal of life-sustaining therapy and during subsequent TA-NRP.

Keywords: Thoraco-abdominal normothermic regional perfusion (TA-NRP); donation after circulatory death (DCD); heart donation; heart transplantation; transoesophageal echocardiography (TOE).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Echocardiography, Transesophageal
  • Heart Transplantation* / methods
  • Humans
  • Perfusion / methods
  • Tissue Donors
  • Tissue and Organ Procurement*