{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:07:37Z","timestamp":1783944457930,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"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":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The number of heart allografts obtained from donation after circulatory death (DCD) remains low, especially compared to donation after brain death (DBD). Our study aimed to identify factors associated with the underutilization of hearts in ideal donors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patient\u2010level data were obtained from the United Network for Organ Sharing (UNOS) database for all adult deceased donors who underwent organ procurement and subsequent transplantation between January 2020 and December 2023. \u201cIdeal\u201d DCD donors were analyzed as a separate subset and compared with ideal DBD donors. Transplantation rates, along with associated factors, were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The rate of heart allograft utilization was 6.9% in DCD donors compared to 35.4% among DBD donors (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Subgroup analysis of ideal donors demonstrated that 41% of DCD donors were utilized for heart transplantation compared to 85% of DBD donors (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Multivariable logistic regression analysis for heart utilization demonstrated that interventions, including extracorporeal life support (odds ratio [OR] 7.48, 95% CI 4.72\u201312.35) and coronary angiography (OR 2.77, 95% CI 1.76\u20134.39), were independent predictors of utilization. There was no significant association with hypertension (OR 0.75, 95% CI 0.52\u20131.06), tobacco use (OR 0.71, 95% CI 0.47\u20131.06), or BMI (OR 0.99, 95% CI 0.97\u20131.01) in the ideal DCD donor. Regional variation in donor heart utilization rates was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There remains a significant portion of ideal DCD donors whose hearts remain unutilized. Identifying and addressing factors related to underutilization may improve organ yield.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70266","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T14:39:35Z","timestamp":1755873575000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart Allograft Utilization Rates Following Donation After Circulatory Death Compared to Donation After Brain Death in the Ideal Heart Donor"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6476-7751","authenticated-orcid":false,"given":"Nayeem","family":"Nasher","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8055-6101","authenticated-orcid":false,"given":"Daler","family":"Rahimov","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7785-5766","authenticated-orcid":false,"given":"T. Reese","family":"Macmillan","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faizaan","family":"Siddique","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Eduardo","family":"Rame","sequence":"additional","affiliation":[{"name":"Division of Cardiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard J.","family":"Eisen","sequence":"additional","affiliation":[{"name":"Division of Cardiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene J.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Division of Cardiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshava","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Entwistle","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4357-3533","authenticated-orcid":false,"given":"Vakhtang","family":"Tchantchaleishvili","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.020"},{"key":"e_1_2_10_3_1","unstructured":"National Data\u2014OPTN. Accessed July 16 2024.https:\/\/optn.transplant.hrsa.gov\/data\/view\u2010data\u2010reports\/national\u2010data\/."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212438"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.10.021"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.11.084"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.05.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.07.019"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2024.07.004"},{"key":"e_1_2_10_11_1","unstructured":"Guidance on Requested Deceased Donor Information\u2014OPTN. Accessed July 28 2024.https:\/\/optn.transplant.hrsa.gov\/policies\u2010bylaws\/public\u2010comment\/guidance\u2010on\u2010requested\u2010deceased\u2010donor\u2010information\/."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741\u2010021\u201010178\u20107"},{"issue":"103","key":"e_1_2_10_13_1","first-page":"1","article-title":"Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease: United States, 1999\u20102010","author":"Fryar C.","year":"2012","journal-title":"NCHS Data Brief"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.0020"},{"key":"e_1_2_10_15_1","unstructured":"ELSO Guidelines | Extracorporeal Membrane Oxygenation (ECMO). Accessed July 28 2024.https:\/\/www.elso.org\/ecmo\u2010resources\/elso\u2010ecmo\u2010guidelines.aspx."},{"key":"e_1_2_10_16_1","unstructured":"TransMedics Receives FDA Approval for Its OCS Heart System Enabling Broader Utilization of Donor Hearts for Transplantation in the U.S.\u00ad | TransMedics. Accessed September 25 2024.https:\/\/investors.transmedics.com\/news\u2010releases\/news\u2010release\u2010details\/transmedics\u2010receives\u2010fda\u2010approval\u2010its\u2010ocs\u2010heart\u2010system\u2010enabling\/."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.26281"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001455"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.26437"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.02.003"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60261\u20106"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003430"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.01.018"},{"key":"e_1_2_10_24_1","unstructured":"Ethical Considerations\u2014OPTN. 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