First Intraoperative Cardiac Catheterization During Donor Normothermic Regional Perfusion

Heart transplantation continues to be the definitive treatment option for end-stage heart failure, but its availability remains limited by the imbalance between the supply and demand of suitable donor organs. Recent advances in the field have underscored the feasibility of expanding the pool of candidate heart donors, as illustrated by the successes of donation after circulatory death (DCD) and extended criteria donor (ECD) allografts. However, the information available to evaluating centers for coronary assessment in DCD hearts is variable and frequently limited. Here, we present an innovative technique for DCD donor coronary angiography performed during normothermic regional perfusion (NRP). To our knowledge, this is the first case of an on-table cardiac catheterization to be performed in a DCD heart donor during NRP support. Additional studies are needed to determine how this technique could be implemented to increase DCD organ utilization, and, in doing so, save lives.