Heart Transplantation and Donation After Circulatory Death in Children. A Review of the Technological, Logistical and Ethical Framework

Louise Amelia Kenny*, Liz Armstrong, Marius Berman, Joe Brierley, David Crossland, John Dark, Dale Gardiner, Stephen Ralph Large, Derek Manas, Mohamed Nassar, David Shaw, Emma Simpson

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Heart transplant for adults following Donation after Circulatory Death (DCD) is well established in many parts of the world, including the United Kingdom (UK). Small child DCD hearts have now been recovered in the UK and internationally utilising novel technologies. Despite these recent advances, extension of this practice to pediatric cardiac transplantation has been slow and difficult despite the severe shortage of donors for children leading to a high number of deaths annually of children waiting for heart transplant. This is in direct contrast with the thriving UK programme of adult DCD heart transplant and pediatric DCD donation for non-cardiac organs. There has been insufficient action in addressing this inequality thus far. Barriers to development of a pediatric cardiac DCD programme are multifaceted: ethical concerns, technological paucity, financial and logistical hurdles. We describe the background, live issues, current developments and how we are driving resources toward a sustainable DCD programme for small children in the UK to provide valuable insights to other countries of the elements and principles at play. This is a call to responsible bodies to take urgent and achievable actions to establish an equitable paediatric DCD cardiac programme for donors, recipients and their families.
Original languageEnglish
Article number13801
Number of pages12
JournalTransplant International
Volume38
DOIs
Publication statusPublished - 14 Feb 2025

Keywords

  • pediatric organ donation
  • pediatric heart transplantation
  • donation after circulatory death (DCD)
  • hypothermic organ perfusion
  • <italic>ex-situ</italic> heart perfusion
  • NORMOTHERMIC REGIONAL PERFUSION
  • ORGAN DONATION
  • CARDIAC DEATH
  • DONOR HEART
  • EARLY OUTCOMES
  • DCD
  • PRESERVATION
  • ISSUES
  • LEGAL
  • 1ST

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