Cardiovascular Surgeons Perform the Health System’s First Donation After Circulatory Death Heart Transplant
UC San Francisco surgeons have performed the health system’s 20,000th solid organ transplant, making it just the third in the nation to reach that milestone. The surgery also marked UCSF Health’s first donation after circulatory death (DCD) heart transplant, a procedure performed by only about twenty health systems in the U.S.
The milestone transplant occurred after a donated heart from the Southeastern U.S. became available for transplantation. The recipient, a 45-year-old woman with end-stage heart failure, is currently recovering at UCSF from the heart transplant.
Traditionally, heart donations have depended on a determination of brain death. Donation after circulatory death occurs after the heart has stopped beating and there is a determination of cardiopulmonary death. In this case, the heart was kept viable by the UCSF Health recovery team using an ex-vivo perfusion machine that allowed the heart to beat outside the body for 10 ½ hours before successfully being transplanted into the patient.
“Transplantation is a complex procedure that requires the expertise of clinical and non-clinical individuals across our health system,” said Suresh Gunasekaran, president and CEO of UCSF Health. “I want to acknowledge the talented individuals who comprise UCSF Health Transplant Services, as well as the Advanced Heart Failure Comprehensive Care Center, and everyone who works together as a team to ensure our patients and families receive the highest level of compassionate, high-quality care during a vulnerable time in their lives."
A national trial that concluded in 2021 showed superior one-year survival with hearts from DCD donors compared to hearts from brain death donors.The ability to performDCD transplants has also expanded the organ donor pool.
“I think DCD has the potential to impact the number of heart transplants available to patients with advanced heart failure more profoundly than any other intervention within the last 30 years, since the introduction of Cyclosporin A,” said Jason Smith, MD, FACS, who performed the 20,000th surgery and is a UCSF professor of clinical surgery as well as surgical director of Heart Transplant and Mechanical Circulatory Support. “We are so excited to be able to offer this therapy to our patients at UCSF.”
Artificial Heart Program on Horizon
To date, UCSF cardiovascular surgeons from the Advanced Heart Failure Comprehensive Care Center have performed a total of 507 heart transplants, including those involving multiple organs. So far in 2022, there have been 44 heart transplants and the center’s ex-vivo organ perfusion program has enabled the donation of organs from as far away as Florida and Alaska. The heart center program has an active hepatitis C donor utilization program and will begin a total artificial heart program in 2023.
UCSF Health’s Organ Transplant Program is one of the largest and most highly regarded in the world. In 2022, UCSF ranked as the second largest transplant center in the U.S., with the program performing about 60 transplants per month. Survival rates for UCSF Health patients are among the highest in the nation, even though the hospital treats some of the most seriously ill patients and accepts the most challenging cases from other institutions. Since the program's founding in 1964, it has grown to include transplants of the kidneys, liver, heart, lungs and pancreas.
The transplant program is also the largest living donor liver program on the West Coast and the third largest in the country. UCSF’s lung program has the best outcomes in the country. In partnership with the National Kidney Registry, UCSF performs the most living donor paired exchange kidney transplants in the country. UCSF surgeons performed one of the first HIV+ to HIV+ transplants in the U.S.