{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:54:59Z","timestamp":1790564099900,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Controlled donation after circulatory death (cDCD) with thoracoabdominal normothermic regional perfusion (TA\u2010NRP) has emerged worldwide as a strategy to expand the heart donor pool. In Italy, however, its implementation is constrained by a particularly restrictive setting, shaped by the mandatory 20\u2010min asystolic no\u2010touch period and by the absence of cardiac surgery units in most donor hospitals. Against this backdrop, the Emilia\u2010Romagna Regional Transplant Network developed a mobile DCD Heart Team capable of performing TA\u2010NRP in peripheral hospitals. We report a case series of 19 cDCD donors managed with TA\u2010NRP within a regional program based at a high\u2010volume tertiary university hospital, all with prolonged functional warm ischemic time (FWIT). Seventeen hearts (89.5%) were successfully procured and transplanted, with a median FWIT of 41 (37.5\u201352) minutes, and serial transesophageal echocardiography and hemodynamic assessment supported real\u2010time monitoring of myocardial recovery. No recipient required postcardiotomy veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO), and no primary graft dysfunction or 30\u2010day mortality were observed. These findings support TA\u2010NRP heart procurement as a feasible and clinically effective procedure\u2014even in centers without onsite cardiac surgery\u2014when a dedicated mobile heart team is available, thereby encouraging the broad adoption of cDCD heart procurement within the Italian legislative and organizational context.<\/jats:p>","DOI":"10.1111\/aor.70255","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:55:37Z","timestamp":1790560537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart Donation After Controlled Circulatory Death in Noncardiac Surgery Hospitals With a Mobile Heart Team: A Case Series From an Italian Regional Program and Integrated Review of the Literature"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7357-7180","authenticated-orcid":false,"given":"Maria","family":"Benedetto","sequence":"first","affiliation":[{"name":"Cardio\u2010Thoracic and Vascular Anesthesia and Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-630X","authenticated-orcid":false,"given":"Valentina","family":"Roncarati","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic and Vascular Anesthesia and Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Campana","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic and Vascular Anesthesia and Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2478-4406","authenticated-orcid":false,"given":"Erika","family":"Cordella","sequence":"additional","affiliation":[{"name":"Coordination for Transplants Center (CRT\u2010ER) IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6833-7480","authenticated-orcid":false,"given":"Domenico","family":"Nocera","sequence":"additional","affiliation":[{"name":"Anesthesiology and General Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4627-4958","authenticated-orcid":false,"given":"Sofia","family":"Martin\u2010Suarez","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department IRCCS Azienda Ospedaliero Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Botta","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department IRCCS Azienda Ospedaliero Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Pacini","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department IRCCS Azienda Ospedaliero Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3791-8388","authenticated-orcid":false,"given":"Letizia","family":"Perinati","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Verona University Hospital  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7909-6399","authenticated-orcid":false,"given":"Massimo","family":"Baiocchi","sequence":"additional","affiliation":[{"name":"Anesthesiology and General Intensive Care Unit Ospedale Infermi di Rimini, AUSL della Romagna  Rimini Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9676-3595","authenticated-orcid":false,"given":"Tommaso","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Anesthesiology and General Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-1976","authenticated-orcid":false,"given":"Fabrizio","family":"Monaco","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic and Vascular Anesthesia and Intensive Care Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1016\/S0140-6736(15)60038-1","article-title":"Adult Heart Transplantation With Distant Procurement and Ex\u2010Vivo Preservation of Donor Hearts After Circulatory Death: A Case Series","volume":"385","author":"Dhital K. K.","year":"2015","journal-title":"Lancet"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.healun.2017.10.021","article-title":"Outcome After Heart Transplantation From Donation After Circulatory\u2010Determined Death Donors","volume":"36","author":"Messer S.","year":"2017","journal-title":"Journal of Heart and Lung Transplantation"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/j.jacc.2023.08.006","article-title":"Outcomes of Heart Transplant Donation After Circulatory Death","volume":"82","author":"Siddiqi H. K.","year":"2023","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_10_5_1","article-title":"Early Outcomes of Heart Transplantation Using Donation After Circulatory Death Donors in the United States","volume":"15","author":"Kwon J. H.","year":"2022","journal-title":"Circulation Heart Failure"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/973758","article-title":"Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: \u2018Medicalization\u2019 of Dying Versus Medical Mission","volume":"2014","author":"Frati P.","year":"2014","journal-title":"BioMed Research International"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/TP.0000000000002570","article-title":"Organ Procurement and Transplantation in Italy","volume":"103","author":"Costa A. N.","year":"2019","journal-title":"Transplantation"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jcrc.2016.10.028","article-title":"Making a Case for Controlled Organ Donation After Cardiac Death: The Story of Italy's First Experience","volume":"38","author":"Vergano M.","year":"2017","journal-title":"Journal of Critical Care"},{"issue":"6","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1007\/s00134-014-3242-7","article-title":"International Guideline Development for the Determination of Death","volume":"40","author":"Shemie S. D.","year":"2014","journal-title":"Intensive Care Medicine"},{"issue":"8","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1503\/cmaj.060895","article-title":"National Recommendations for Donation After Cardiocirculatory Death in Canada: Donation After Cardiocirculatory Death in Canada","volume":"175","author":"Shemie S. D.","year":"2006","journal-title":"CMAJ: Canadian Medical Association Journal"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s13054-015-0985-7","article-title":"Protocols for Uncontrolled Donation After Circulatory Death: A Systematic Review of International Guidelines, Practices and Transplant Outcomes","volume":"19","author":"Ortega\u2010Deballon I.","year":"2015","journal-title":"Critical Care"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"2846","DOI":"10.1111\/ajt.12927","article-title":"In Situ Normothermic Regional Perfusion for Controlled Donation After Circulatory Death\u2014The United Kingdom Experience","volume":"14","author":"Oniscu G. C.","year":"2014","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.5500\/wjt.v14.i4.97860","article-title":"Normothermic Regional Perfusion Mobile Teams in Controlled Donation After Circulatory Death Pathway: Evidence and Peculiarities","volume":"14","author":"Lazzeri C.","year":"2024","journal-title":"World Journal of Transplantation"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375\u20109393.16.11736\u20105"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.02.027"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002282"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2025.09.003"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16446"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab139"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.101887","article-title":"The International Experience of In\u2010Situ Recovery of the DCD Heart: A Multicentre Retrospective Observational Study","volume":"58","author":"Louca J.","year":"2023","journal-title":"EClinicalMedicine"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2024.06.007"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2025.04.003"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005725"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2026.04.027"},{"key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jtcvs.2024.10.033","article-title":"Direct Procurement With Machine Perfusion and Normothermic Regional Perfusion in Donation After Circulatory Death Heart Transplantation","volume":"170","author":"Goodwin M. 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E.","year":"2021","journal-title":"Journal of Heart and Lung Transplantation"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2025.03.037"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15024"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1111\/ajt.12782","article-title":"Increasing the Tolerance of DCD Hearts to Warm Ischemia by Pharmacological Postconditioning","volume":"14","author":"Iyer A.","year":"2014","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.21037\/acs-2024-dcd-0098","article-title":"The Anesthetist Perspective: Optimization of Cardiac Allograft From Withdrawal of Life Support to Reperfusion in the Controlled Donation After Circulatory Death","volume":"14","author":"Zanierato M.","year":"2025","journal-title":"Annals of Cardiothoracic Surgery"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14783"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70255","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.70255","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:55:41Z","timestamp":1790560541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.70255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":32,"alternative-id":["10.1111\/aor.70255"],"URL":"https:\/\/doi.org\/10.1111\/aor.70255","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"assertion":[{"value":"2026-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aor.70255"}}