Heart failure affects 6.2 million adults in the United States (US), resulting in a
decrease in quality of life. Limited options exist for the treatment of end-stage
heart failure. Mechanical circulatory support and transplantation are considered when
no further optimization can be obtained with medical management. Heart transplant
is regarded as superior to mechanical assist devices due to a lower incidence of multiorgan
dysfunction. However, transplants are limited by the availability of donor organs.
Heart transplants using organs from donation after circulatory death (DCD) have blossomed
globally since 2014; whereas, in the US, this method has had a slower implementation.
Today, the realization of the need to increase the number of donor hearts has reinvigorated
the interest in heart transplantation using DCD organs. The authors review the process
and discuss the unique opportunities anesthesiologists have to impact the future success
of DCD heart transplantation as it continues to expand.
Key Words
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Published online: May 22, 2022
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