Types of heart donation
Hearts are donated by deceased donors either after brain death or circulatory death
Key points
- Hearts are donated by deceased donors either after brain death or circulatory death
- Traditionally all transplanted hearts in the last 40 years have come from donation after brain death donors
- Since 2015, a few centres in the UK have started using hearts from donors whose hearts have stopped beating (circulatory death)
- Hearts from both types of donors can be used safely and have similar outcomes
Types of heart donation
Hearts can be donated in one of two ways:
Donation after Brain Death (DBD) donors
Most donors are declared dead after tests that establish brain death (DBD donors). They are supported on a ventilator as they cannot breathe for themselves but the heart continues to beat. Traditionally all transplanted hearts in the last 40 years have come from such donors.
Donation after Circulatory Death (DCD) donors
Since 2015, a few centres in the UK have started using hearts from donors whose hearts have stopped beating. Historically these donors have only been able to donate kidneys, livers and lungs as it was felt that the heart would have suffered injury and would not be safe to use.
We now know that these hearts can be used safely. Rather than transporting the still heart from donor to recipient packed in ice, DCD hearts are transported in the beating state in a special machine with a solution containing nutrients supplying the arteries of the heart. The deceased donor's heart can be restarted on the machine and tested to see if it will function well enough for transplantation.
More than 100 such transplants have been carried out in the UK and the outcome at one year is similar to hearts transplanted from DBD donors. We think it is unlikely that longer-term outcomes will be different, but will continue to study patients who have received a heart from a DCD donor. The use of DCD hearts has increased the number of heart transplants significantly.
