Cardiac Allograft Vasculopathy in Heart Transplantation From Circulatory Death Donors: A Systematic Review and Meta-Analysis.
Safdar, W., et al.Clin Transplant. 2026 Jan;40(1):e70435.
Aims
The study aimed to compare the 1-year incidence of cardiac allograft vasculopathy (CAV) and mortality between heart transplant recipients receiving hearts from donation after circulatory death (DCD) versus donation after brain death (DBD) donors.
Interventions
Literature was seached using the PubMed and MEDLINE databases. Two reveiwers independently identified and included eligible studies and extracted data using a standardized data collection form. The risk of bias was assessed using the the Newcastle–Ottawa scale (NOS) for observational studies.
Participants
4 studies were included in the review.
Outcomes
1-year incidence of CAV and 1-year mortality.
Follow-up
N/A
CET Conclusions
This systematic review aimed to synthesise the available evidence investigating the occurrence of 1-year CAV and 1-year mortality between recipients of heart transplant from donation after circulatory death (DCD) versus donation after brain death (DBD) donors. Study selection and data extraction were perfromed in duplicate. Only four studies met the inclusion criteria, all of which were restrospective cohort studies. The authors found that both the incidence of 1-year CAV and 1-year mortality was similar between the DCD and DBD recipients. The meta-analyses showed no heterogeneity for both outcomes. Overall the methodology of the study is sound. The main limitations are the small number of studies in the meta-analysis reducing statistical power, as well as the included studies being observational in nature which may have introduced bias. While the authors recommend the continuation and expansion of DCD donors to deal with the issue of organ shortages, they do acknowledge that long-term data regarding the increased risk of CAV and mortality in DCD heart transplant recipients remains insufficient.
Trial registration
N/A