Donor Management

Ronald Figura, Charles Fraser, Robert S. D. Higgins, Ahmet Kilic

Key Points

  • Donor selection and management techniques are rapidly evolving.
  • Optimal recipients are paired with optimal donors via a multidisciplinary and thorough evaluation that may vary by center.
  • Age, blood type, BMI, and sex are among the most important factors when considering donor and recipient characteristics. Donor age less than 60 years, BMI within 30% of the recipient’s, and sex matching offer the best outcomes.
  • Organ protection and transportation strategies are continually improving. While cold ischemic times of less than 6 hours are preferable, novel techniques utilizing ex-vivo autoperfusion may allow for acceptable outcomes with longer transport times.
  • The donor pool is expanding through the use of marginal / high-risk donors, ex-vivo perfusion strategies, and donation after cardio-circulatory death (DCD). The number of hearts transplanted using these criteria is increasing year after year.

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Last updated: July 31, 2023