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News
Donation after circulatory death (DCD) heart transplants are expanding worldwide, with new data from Spain, Italy, and the US showing outcomes comparable to the traditional brain-death donation method. Despite regional differences in protocols — like Italy's stricter 20-minute no-touch rule — survival rates remain solid. Experts say the field is maturing fast, but greater standardization across countries is needed to fully unlock its potential.
Heart transplants using organs from donors who have died from circulatory (rather than brain) death are rapidly gaining ground globally — and new real-world data suggest the approach is holding up well. Presented at the 2026 European Association for Cardio-Thoracic Surgery (EACTS) meeting, studies from Spain, Italy, and the US all point to DCD transplant outcomes that are comparable to the traditional donation after brain death (DBD) method, even as programs scale up and take on higher-risk patients.
In Spain, DCD transplants grew from just 1.4% to nearly 35% of all heart transplants between 2021 and 2025, with 1-year survival matching DBD recipients. Italy, operating under a stricter 20-minute no-touch rule post-circulatory arrest, reported 77.5% survival at 12 months across 100 DCD transplants. Meanwhile, a US UNOS registry analysis of 1,489 DCD recipients found stable 1-year mortality and graft failure rates across early and late eras of adoption, even as recipient complexity increased and the number of participating centers tripled from 22 to 67.
By the Numbers
Why it matters: DCD transplants offer a critical pathway to expand the donor pool amid persistent organ shortages. As global experience grows, the data increasingly support the safety and scalability of this approach — though experts stress that harmonizing procurement protocols across regions will be key to advancing the field further.
