Survival Noninferior With Heart Donated After Circulatory Death

FRIDAY, June 9, 2023 (HealthDay News) — Risk-adjusted survival at six months after transplantation is noninferior for patients receiving a heart after the circulatory death of a donor or after brain death of a donor, according to a study published in the June 8 issue of the New England Journal of Medicine.

Jacob N. Schroder, M.D., from Duke University Medical Center in Durham, North Carolina, and colleagues conducted a randomized, noninferiority trial involving adult candidates for heart transplantation who were assigned to receive a heart after the circulatory death of the donor or a heart from a donor after brain death if that heart was available first or to receive only a heart that had been preserved with the use of traditional cold storage after the brain death of the donor (circulatory-death and brain-death groups, respectively). Risk-adjusted survival at six months was examined as the primary end point.

The as-treated primary analysis included 80 patients who received a heart from a circulatory-death donor and 86 who received a heart from a brain-death donor. The researchers found that in the as-treated population, the risk-adjusted six-month survival was 94 and 90 percent among recipients of a heart from a circulatory-death donor and from a brain-death donor, respectively (least-squares mean difference, −3 percentage points). No substantial differences were seen between the groups in the mean per-patient number of serious adverse events associated with the heart graft at 30 days posttransplant.

“This should eliminate any barriers for transplant centers to offer this to their patients because we now have objective, randomized data showing both types of hearts are equivalent,” Schroder said in a statement.

The study was funded by TransMedics.

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