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April 19, 2026The Journal of Heart and Lung Transplantation1 citationsOpen Access

A comparison of DCD Heart Transplantation in Europe and the United States: A multi-centre, retrospective study

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JLJohn O. LoucaMÖMarco ÖchsnerASAshish Shah

Key Points

  • The central aim is to compare donor and recipient demographics, intraoperative parameters, and outcomes of DCD heart transplantation between Europe and the US.
  • Retrospective observational study across 22 heart transplantation centres in Europe and the US.
  • Included patients undergoing DCD heart transplantation since the initiation of each centre's DCD program until January 1, 2023.
  • Primary outcome measured was 1-year survival; secondary outcomes were major graft dysfunction and cellular rejection incidence.
  • 223 patients from Europe and 281 from the US were included in the analysis.
  • DCD donors in Europe were significantly older than those in the US (37 years vs 28 years; p<0.001).
  • 1-year survival was lower in Europe compared to the US (86.6% vs 91.8%; p=0.043).
  • Survival rates at 1-month and 3-years were comparable between regions.
  • The use of mechanical circulatory-assist post-transplantation was higher in Europe (17.9% vs 11%; p=0.03).

Abstract

AbstractBackground Donation after the circulatory determination of death (DCD) heart transplantation (HT) is becoming more widely adopted across the United States (US) and Europe. Objective This study compared donor and recipient demographics, intraoperative parameters and outcomes between DCD HT centres in Europe and the US that contributed to the Outcomes after DCD Cardiac Transplantation Database. Methods This was a retrospective observational study across 22 HT centres in Belgium, Spain, United Kingdom (UK) and US. All patients undergoing DCD HT at participating centres, from the start of each centre's DCD program through 01/01/2023 were included with censor date 01/01/2024. The primary outcome was 1-year survival. Secondary outcomes included severe primary graft dysfunction and incidence of acute cellular rejection. Results Data from 223 patients in Europe and 281 in the US were analysed. DCD donors in Europe were significantly older (37years vs 28 years;pConclusion This study further confirms the safety and efficacy of DCD HT across centres in the US and Europe, despite important differences in donor and recipient demographics and clinical outcomes. Continued collection of international data may identify opportunities to improve outcomes.

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Cite This Study

Louca et al. (2026) studied this question.

synapsesocial.com/papers/69e470a4010ef96374d8d956https://doi.org/10.1016/j.healun.2026.04.007
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