Whilst Donation after Circulatory Death (DCD) heart recovery has increased adult transplant activity significantly, pediatric application has been lagging. Followed by pre-clinical DCD experiments, six (6) pediatric donor hearts were recovered (3 DCD and 3 Donation after Brainstem Death (DBD)), preserved with HOPE and successfully transplanted. Donor age and weight ranges were 16 months – 13 years / 9 – 63 kg and recipients 22 months – 13 years / 12 – 40 kg, respectively. For small donors, this required a pediatric research cannula and surgical techniques such as arch augmentation. For the DCD cohort, median functional warm ischemic time was 19 minutes and there was no severe primary graft dysfunction. Survival at follow-up (median 287.5 days) was 100% and echocardiograms showed normal systolic function.
HOPE enables viable pediatric DCD heart transplantation, offering a promising solution to expand the donor pool for infants and children.
“We call upon clinicians and policymakers to support DCD-HOPE to provide equity for child donors and recipients.”
Chilvers et al 2025
J Heart Lung Transplant, 2025 / DOI: doi.org/10.1016/j.healun.2025.09.020
