TY - JOUR
T1 - Heart Transplantation and Donation After Circulatory Death in Children. A Review of the Technological, Logistical and Ethical Framework
AU - Kenny, Louise Amelia
AU - Armstrong, Liz
AU - Berman, Marius
AU - Brierley, Joe
AU - Crossland, David
AU - Dark, John
AU - Gardiner, Dale
AU - Large, Stephen Ralph
AU - Manas, Derek
AU - Nassar, Mohamed
AU - Shaw, David
AU - Simpson, Emma
PY - 2025/2/14
Y1 - 2025/2/14
N2 - 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.
AB - 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.
KW - pediatric organ donation
KW - pediatric heart transplantation
KW - donation after circulatory death (DCD)
KW - hypothermic organ perfusion
KW - <italic>ex-situ</italic> heart perfusion
KW - NORMOTHERMIC REGIONAL PERFUSION
KW - ORGAN DONATION
KW - CARDIAC DEATH
KW - DONOR HEART
KW - EARLY OUTCOMES
KW - DCD
KW - PRESERVATION
KW - ISSUES
KW - LEGAL
KW - 1ST
U2 - 10.3389/ti.2025.13801
DO - 10.3389/ti.2025.13801
M3 - (Systematic) Review article
SN - 0934-0874
VL - 38
JO - Transplant International
JF - Transplant International
M1 - 13801
ER -