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Short-Term Outcomes of Pediatric DCD Heart Transplantation Using NRP and DPP Techniques
Abstract   Peer reviewed

Short-Term Outcomes of Pediatric DCD Heart Transplantation Using NRP and DPP Techniques

J. Song, J. White, P. Cho, H. Zappacosta, S. McKay, M. Daniel, A. Abramov, A. Ardehali and M. Husain
The Journal of heart and lung transplantation, v 45(5), pp 167-168
Apr 2026

Abstract

Purpose: As donation after circulatory death (DCD) heart transplantation expands, two procurement techniques—normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP)—enable graft recovery in different donor size populations. However, comprehensive evaluation of short-term outcomes across these strategies remains limited. Methods: The UNOS database was queried for pediatric patients (<18 years) who underwent isolated DCD heart transplantation between 08/2021 and 06/2025. Donor, recipient, and perioperative characteristics were summarized using medians (IQR) and means ± SD for continuous variables. Practice patterns and short-term outcomes were characterized, and six-month survival estimated by Kaplan-Meier analysis. Results: Among 44 pediatric DCD heart transplant recipients, 24 (55%) underwent NRP and 20 (45%) underwent DPP. NRP recipients had a median age of 2 [4] years, with 83% listed as UNOS Status 1A. DPP recipients had a median age of 11 [4] years, with 50% listed as Status 1A. NRP donors had a median age of 3 [4] years, while DPP donors had a median age of 17 [7] years (Table 1). Acute rejection occurred in 6% of NRP and 16% of DPP recipients. Thirty-day graft failure and in-hospital mortality were 5% for NRP and 0% for DPP. Median post-transplant stay was 43 [21-56] days for NRP and 30 [20-65] days for DPP. Six-month survival was 83.4% for NRP and 100% for DPP (Figure 1). Conclusion: This descriptive evaluation highlights early outcomes of pediatric DCD heart transplantation using NRP and DPP, providing benchmarks to guide future donor selection and procurement strategies as pediatric DCD experience evolves.

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