Doctors attached to the UMC Utrecht, Erasmus MC and UMC Groningen have performed the first DCD heart donation procedures in the Netherlands. The arrested heart of a deceased donor is placed outside the body in a machine where it starts beating again upon being supplied with oxygen and blood. The heart is then transplanted.

Circulation stop
Heart donation was previously only possible with a brain-dead donor. However, the hearts of more than half of the deceased donors (150 out of 250 donors in 2020), have been donated after circulatory arrest (DCD, Donation after Circulatory Death). Until recently, all organs of these DCD donors could be transplanted, except for the heart. A nationwide shortage of donor hearts was the reason for the UMCs to use this technique in the Netherlands in cooperation with the Netherlands Transplant Foundation (NTS) and the Ministry of Health, Welfare and Sport (VWS).

Donor heart waiting list
There are around 120 heart patients on the waiting list for a donor heart every year. Waiting list mortality is high. One in seven patients dies because a donor heart is not available in time.

Cardiothoracic surgeon Niels van der Kaaij, UMC Utrecht: “The 3 UMCs have calculated that DCD heart donation can ultimately yield about forty additional heart donors a year: double the current number of heart transplants. And that is desperately needed, because the enormous shortage of donor hearts means that people on the waiting list are dying every year.”

DCD heart donation worldwide
The DCD heart donation procedure (heart-in-a-box) has already been implemented in a few countries worldwide, including Australia, USA, Belgium, UK and Spain. Recently, the National Health Service (UK) reported that six children between the ages of 12 and 16 had been saved thanks to DCD heart donation.

The procedure has been made possible in the Netherlands thanks to a grant from the Ministry of Health, Welfare and Sport and cooperation between three UMCs: UMC Utrecht, UMC Groningen and Erasmus MC. The NTS regulated the frameworks within which the project could be rolled out nationwide. The NTS has been designated by law as an organ center and works together with hospitals and transplantation centers on organ and tissue donation and transplantation on behalf of the Ministry of Health, Welfare and Sport.

• Video: machine in operation with beating heart
• Video: close-up of beating heart in machine
• Infographic DCD procedure
• Question and answer heart transplantation after circulatory arrest
• Animation DCD Procedure on YouTube