2025 HFSA Contemporary Issues in Heart Failure - OnDemand-Donor Heart Selection

Video Transcription

Video Summary

Dr. Palak Shah, medical director of the MCS and Heart Failure Research programs at Inova, presents on donor heart selection for transplantation. She emphasizes focusing on key donor and recipient factors over less impactful data when assessing organ offers. Heart transplant volumes have nearly doubled in the past decade, though the U.S. accepts fewer donor hearts than Europe, partly due to conservatism around older donors and marginal hearts. Recipient risk outweighs donor risk in post-transplant outcomes, and donor age alone should not exclude use—especially if ischemic times are minimized. The predicted heart mass metric improves donor-recipient size matching, reducing risks like primary graft dysfunction. Donation after circulatory death (DCD) offers survival outcomes comparable to brain-dead donors. Advances in nucleic acid testing mitigate infectious risks, supporting greater use of Public Health Service criteria donors. Cardiac evaluation involves repeated echocardiograms for donor EF, coronary angiograms, and careful matching based on sensitization to optimize outcomes. Overall, more aggressive yet informed donor acceptance could expand the donor pool safely.

Keywords

donor heart selection

heart transplantation

recipient risk assessment

predicted heart mass

donation after circulatory death

nucleic acid testing