Results:

Between January 2020 and January 2023, 385 patients underwent heart transplant at VUMC: 263 received DBD hearts and 122 received DCD hearts. The median follow-up time was 511 days. Compared to DBD donors, DCD donors were younger, more likely to be White, and more likely to be male; they were also less likely to have hypertension, significant smoking history, or positive nucleic acid test for hepatitis C. DCD donors more often died of blunt injury, while DBD donors tended to die of drug intoxication. DCD recipients were more often male and White, and had significantly higher body mass index and glomerular filtration rate. They were less often on temporary mechanical support or hospitalized prior to transplant and more often supported by left ventricular assist device at the time of transplant. Eighty-three percent of the DCD hearts were recovered using NRP and 17% recovered using EVP; 96% of DBD hearts were recovered using static cold storage.

One-year survival after transplant was 94.3% in the DCD recipients and 92.4% in the DBD recipients (hazard ratio, 0.77; 95% confidence interval, 0.32-1.81; p = 0.54). Survival to discharge, at 30 days, and at 6 months was similar between DCD and DBD recipients. The incidence of severe primary graft dysfunction (PGD) was 5.75% in both groups (p = 0.99). Finally, there was no difference in cardiac allograft vasculopathy (CAV), treated rejection, median hospital length of stay (LOS) or readmission within 30 days between DCD and DBD recipients.