Distinct goal-directed perfusion signatures in donation after brain death versus circulatory death heart…

Cohort studyJHLT open· Nov 2026

Distinct goal-directed perfusion signatures in donation after brain death versus circulatory death heart transplantation.

Chen Chia Wang, Awab Ahmad, Mark Petrovic … Brian Lima

Transplant & Mechanical SupportCohort studyClinical practiceQ3IF 1.3

Circulatory-death donor hearts show higher oxygen extraction after transplant reperfusion

Distinct goal-directed perfusion signatures in donation after brain death versus circulatory death heart transplantation.

Chen Chia Wang … Brian Lima

JHLT open · Nov 2026 · Q3 in Respiratory Medicine

Background

Continuous oxygen extraction ratio (O2ER) monitoring during cardiopulmonary bypass is an emerging strategy to support goal-directed perfusion (goal-directed perfusion) during heart transplantation (heart transplantation).

Methods

Adult heart transplantation at a single center (10/2021-06/2025) with continuous perfusion data were retrospectively reviewed.

Results

DCD hearts extract more oxygen after reperfusion than DBD hearts

MD by subgroup · 95% CI

More results

Among 322 heart transplantation, 193 (59.9%) were DBD and 129 (40.1%) were DCD.

Pre-reperfusion DO2i and O2ER, and post-reperfusion O2ER were similar between DBD and DCD cohorts.

More results

The interaction term between DCD donor status and pre-reperfusion O2ER was also significantly associated with post-reperfusion O2ER (mean difference -0.27, 95% -0.41 - -0.14).

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Conclusion · 1 of 2

DCD grafts exhibit persistently higher O2ER profiles and reduced metabolic responsiveness to pre-reperfusion optimization.

Conclusion · 2 of 2

These findings underscore the need for individualized, real-time O2ER-guided goal-directed perfusion to dynamically match perfusion to graft and patient-specific metabolic demands.

Distinct goal-directed perfusion signatures in donation after brain death versus circulatory death heart transplantation.

Distinct goal-directed perfusion signatures in donation after brain death versus circulatory death heart transplantation.

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