ISHLT Consensus Statement on Donor Organ Acceptability and Management in Pediatric Heart Transplantation

Published 31 January 2020

Richard Kirk, MA, FRCP, FRCPCH; Anne I. Dipchand, MD, FRCPC; Ryan R. Davies, MD; Oliver Miera, MD; Gretchen Chapman, PhD; Jennifer Conway, MD, FRCPC; Susan Denfield, MD; Jeffrey G. Gossett, MD, FAAP; Jonathan Johnson, MD; Michael McCulloch, MD; Martin Schweiger, MD; Daniel Zimpfer, MD; László Ablonczy, MD; Iki Adachi, MD; Dimpna Albert, PhD; Peta Alexander, MB, BS; Shahnawaz Amdani, MD; Antonio Amodeo, MD; Estela Azeka, MD; Jean Ballweg, MD; Gary Beasley, MD; Jens Böhmer, MD; Alison Butler, BS; Manuela Camino, MD; Javier Castro, MD; Sharon Chen, MD; Maryanne Chrisant, MD; Urs Christen, CRNA, CETC; Lara Danziger-Isakov, MD, MPH; Bibhuti Das, MD; Melanie Everitt, MD; Brian Feingold, MD, MS; Matthew Fenton, MB, BS, BSc; Luis Garcia-Guereta, MD, PhD; Justin Godown, MD; Dipankar Gupta, MD; Claire Irving, MB, ChB, MRCPCH, MD; Anna Joong, MD; Mariska Kemna, MD; Sanjeev Kumar Khulbey, MS, MCh; Steven Kindel, MD; Kenneth Knecht, MD; Ashwin K. Lal, MD; Kimberly Lin, MD; Karen Lord, MSN, FNP-C; Thomas Möller, MD, PhD; Deipanjan Nandi, MD, MSc, FAAP, FACC; Oliver Niesse, MD; David M. Peng, MD; Alicia Pérez-Blanco, PhD, MD; Ann Punnoose, MD; Zdenka Reinhardt, MD; David Rosenthal, MD; Angie Scales, RGN, RSCN; Janet Scheel, MD; Renata Shih, MD, FAAP; Jonathan Smith, MB, ChB, MRCP (UK), FRCA; Jacqueline Smits, MD, MS, PhD; Josef Thul, MD; Robert Weintraub, MB, BS; Steve Zangwill, MD; Warren A. Zuckerman, MD

J Heart Lung Transplant. Jan 2020;39(4):331-341

• Advanced Heart Failure & Transplantation
• Cardiothoracic Surgery
• Consensus Document
• Pediatrics
• Publications & Journals
• Standards & Guidelines

The number of potential pediatric heart transplant recipients continues to exceed the number of donors, and consequently the waitlist mortality remains significant. Despite this, around 40% of all donated organs are not used and are discarded. The non-utilization of donors has many contributing factors, including the absence of any accepted standards or guidelines for pediatric donor heart assessment and subsequent acceptance; the influence of physician and surgeon preferences; disparate regulatory requirements; variability in program quality indicators and expected benchmarks for success; and regional differences in prioritization schemes and healthcare system economics. Additional factors include waitlist times, number of heart donors, listing criteria, recipient acuity, and the availability of bridging devices. 

This consensus statement highlights these differences, evaluates factors responsible for discarding donor hearts, and makes recommendations regarding donor heart acceptance. 

This consensus statement highlights these differences, evaluates factors responsible for discarding donor hearts, and makes recommendations regarding donor heart acceptance. The aim of this statement is to ensure that no usable donor heart is discarded, waitlist mortality is reduced, and post-transplant survival is not negatively impacted.

Read at JHLT