Heart Donation After Controlled Circulatory Death in Noncardiac Surgery Hospitals With a Mobile Heart Team: A Case Series From an Italian Regional Program and Integrated Review of the Literature
7 affiliations
- 1Cardio‐Thoracic and Vascular Anesthesia and Intensive Care Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
- 2Coordination for Transplants Center (CRT‐ER) IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
- 3Anesthesiology and General Intensive Care Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
- 4Division of Cardiac Surgery, Cardiac Surgery Department IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
- 5Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna Bologna Italy
- 6Division of Cardiology, Department of Medicine Verona University Hospital Verona Italy
- 7Anesthesiology and General Intensive Care Unit Ospedale Infermi di Rimini, AUSL della Romagna Rimini Italy
Abstract
Controlled donation after circulatory death (cDCD) with thoracoabdominal normothermic regional perfusion (TA‐NRP) has emerged worldwide as a strategy to expand the heart donor pool. In Italy, however, its implementation is constrained by a particularly restrictive setting, shaped by the mandatory 20‐min asystolic no‐touch period and by the absence of cardiac surgery units in most donor hospitals. Against this backdrop, the Emilia‐Romagna Regional Transplant Network developed a mobile DCD Heart Team capable of performing TA‐NRP in peripheral hospitals. We report a case series of 19 cDCD donors managed with TA‐NRP within a regional program based at a high‐volume tertiary university hospital, all with prolonged functional warm ischemic time (FWIT). Seventeen hearts (89.5%) were successfully procured and transplanted, with a median FWIT of 41 (37.5–52) minutes, and serial transesophageal echocardiography and hemodynamic assessment supported real‐time monitoring of myocardial recovery. No recipient required postcardiotomy veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO), and no primary graft dysfunction or 30‐day mortality were observed. These findings support TA‐NRP heart procurement as a feasible and clinically effective procedure—even in centers without onsite cardiac surgery—when a dedicated mobile heart team is available, thereby encouraging the broad adoption of cDCD heart procurement within the Italian legislative and organizational context.
Related
- The impact of intraoperative use of the inhaled anesthetic desflurane on postoperative recovery quality after noncardiac surgery: a meta-analysis of randomized controlled trials
- Continuous intra-arterial versus noninvasive blood pressure monitoring for preventing hypotension during anesthesia induction in patients aged ≥ 75 years undergoing noncardiac surgery: a randomized controlled trial.
- Modeling the cost-effectiveness of introducing donation after controlled circulatory death for heart transplantation in France
- Experience of Clinicians and Relatives with Donation after Controlled Circulatory Death: A Prospective Qualitative Study
- Carer perceptions of inpatient psychiatric hospitals and the treatment of their loved ones: A meta-review of the literature
BibTeX
@article{benedetto2026heart,
title = {{Heart Donation After Controlled Circulatory Death in Noncardiac Surgery Hospitals With a Mobile Heart Team: A Case Series From an Italian Regional Program and Integrated Review of the Literature}},
author = {Maria Benedetto and Valentina Roncarati and Arianna Campana and Erika Cordella and Domenico Nocera and Sofia Martin‐Suarez and Luca Botta and Davide Pacini and Letizia Perinati and Massimo Baiocchi and Tommaso Tonetti and Fabrizio Monaco},
journal = {Artificial Organs},
year = {2026},
month = sep,
doi = {10.1111/aor.70255},
url = {https://doi.org/10.1111/aor.70255},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Heart Donation After Controlled Circulatory Death in Noncardiac Surgery Hospitals With a Mobile Heart Team: A Case Series From an Italian Regional Program and Integrated Review of the Literature
AU - Maria Benedetto
AU - Valentina Roncarati
AU - Arianna Campana
AU - Erika Cordella
AU - Domenico Nocera
AU - Sofia Martin‐Suarez
AU - Luca Botta
AU - Davide Pacini
AU - Letizia Perinati
AU - Massimo Baiocchi
AU - Tommaso Tonetti
AU - Fabrizio Monaco
PY - 2026
DA - 2026/09/27
JO - Artificial Organs
DO - 10.1111/aor.70255
UR - https://doi.org/10.1111/aor.70255
AB - Controlled donation after circulatory death (cDCD) with thoracoabdominal normothermic regional perfusion (TA‐NRP) has emerged worldwide as a strategy to expand the heart donor pool. In Italy, however, its implementation is constrained by a particularly restrictive setting, shaped by the mandatory 20‐min asystolic no‐touch period and by the absence of cardiac surgery units in most donor hospitals. Against this backdrop, the Emilia‐Romagna Regional Transplant Network developed a mobile DCD Heart Team capable of performing TA‐NRP in peripheral hospitals. We report a case series of 19 cDCD donors managed with TA‐NRP within a regional program based at a high‐volume tertiary university hospital, all with prolonged functional warm ischemic time (FWIT). Seventeen hearts (89.5%) were successfully procured and transplanted, with a median FWIT of 41 (37.5–52) minutes, and serial transesophageal echocardiography and hemodynamic assessment supported real‐time monitoring of myocardial recovery. No recipient required postcardiotomy veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO), and no primary graft dysfunction or 30‐day mortality were observed. These findings support TA‐NRP heart procurement as a feasible and clinically effective procedure—even in centers without onsite cardiac surgery—when a dedicated mobile heart team is available, thereby encouraging the broad adoption of cDCD heart procurement within the Italian legislative and organizational context.
SN - 0160-564X
SN - 1525-1594
ER -