Controlled donation after circulatory death total beating heart transplant: First-in-human experience

Among the different strategies that have been investigated to lower heart ischemia-reperfusion injury in controlled donors after cardiocirculatory death (cDCD), beating heart transplant (HT) has emerged as a promising technique.1 However, the Stanford experience (the largest, to date) still reports a mean cold ischemia time of 40 minutes (whichcorresponds to the time required to stop the heart with cold cardioplegia before implantation in a normothermic perfusion machine).2 Total beating HT (abolishing this cold ischemic time) was first reported by Yin and colleagues3 in 2022; however, the case was performed in the setting of donation after brain death, and it was technically demanding.