Innovative Method Enhances Heart Recovery from Deceased Organ Donors

In a pioneering advancement in organ transplantation, researchers at Vanderbilt University Medical Center have developed a novel technique that enables the recovery of hearts from deceased organ donors after circulatory death (DCD). This groundbreaking method, described in a recent article published in the *New England Journal of Medicine* on July 16, 2025, offers a promising solution to the challenges associated with existing preservation techniques.

The new method, named rapid recovery with extended ultra-oxygenated preservation (REUP), involves the immediate flushing of the donor heart with a cold oxygenated preservation solution following death. This approach addresses significant drawbacks of two traditional methods: normothermic regional perfusion (NRP), which has raised ethical concerns due to its reanimation of the heart within the deceased donor's body, and ex situ perfusion systems that are both costly and technically demanding. According to Dr. Aaron Williams, the lead author of the study and a cardiothoracic surgeon at Vanderbilt, “This is going to be a game changer. This technique will potentially expand the number of donor hearts available worldwide.”

The study highlights the successful application of REUP in 20 heart transplants, starting from November 2024, with outcomes comparable to or better than existing methodologies. Dr. Williams noted that the preservation technique has shown efficacy in maintaining heart viability for durations exceeding four hours, and in some cases, up to eight hours. This innovation not only simplifies the organ recovery process but also significantly reduces costs, thereby enhancing the accessibility of donor hearts for transplantation.

Historically, the use of DCD hearts has transformed the landscape of organ transplantation. Previously, these hearts were often discarded due to perceived risks associated with their condition. However, advancements in preservation techniques at Vanderbilt have enabled the successful recovery of DCD hearts, allowing the institution's thoracic organ recovery teams to extend their search for viable organs across greater distances. Since 2020, the Vanderbilt heart transplant program has shifted from exclusively utilizing organs from donors after brain death (DBD) to increasingly incorporating DCD hearts into its practices.

The implications of this new technique extend beyond heart transplantation. Dr. Williams expressed optimism regarding the potential application of REUP to preserve other organs, such as livers, kidneys, and lungs, suggesting that further studies could confirm its efficacy across different transplant types. The ability to increase the donor pool significantly could have a profound impact on patients awaiting transplantation, potentially saving countless lives.

The collaborative research team at Vanderbilt included a range of medical professionals, such as Dr. John Trahanas, Dr. Swaroop Bommareddi, and Dr. Ashish Shah, among others. Their collective expertise underscores the interdisciplinary nature of this innovation and its potential to reshape organ transplant practices globally.

As the medical community continues to grapple with the shortage of available organs for transplantation, the REUP method represents a critical advancement in the field. By addressing ethical concerns and reducing costs, this technique not only enhances the viability of DCD hearts but also paves the way for a broader acceptance and use of these organs in transplant procedures worldwide. The future of organ transplantation may very well hinge on innovations such as these, which strive to maximize the life-saving potential of available donor organs.