Scientists have introduced a revolutionary organ recovery method—Rapid Recovery with Extended Ultra‑Oxygenated Preservation (REUP)—that restores function to hearts from donors who experienced circulatory death (DCD), effectively “bringing dead donor hearts back to life.”
🔎 Key Highlights
1. What Is REUP?
REUP involves flushing a circulatory-death donor heart with a cold, oxygen-rich preservation solution immediately after death. Unlike prior methods, it does not require reanimating the heart inside the donor or using costly mechanical perfusion devices. It’s simpler, more affordable, and yields comparable outcomes to more invasive approaches
2. Why This Technique Matters
Traditional heart transplants rely on donors who are brain-dead, with the heart still beating. DCD hearts have historically been discarded due to irreversible ischemic damage. REUP offers a way to salvage these hearts, expanding the donor pool and saving lives
3. Clinical Outcomes
Data published in the New England Journal of Medicine shows that recipients of reanimated DCD donor hearts see six-month survival rates similar to those receiving hearts from brain-dead donors—survival rates of 95% versus 89% respectively—with about 89% of retrieved hearts ultimately transplanted successfully
4. Real-World Applications
Several U.S. transplant centers—including Vanderbilt University Medical Center and Duke University—have adopted variations of this approach. Vanderbilt’s team used a warm blood perfusion strategy to reanimate and transplant previously unused DCD hearts, performing over 25 transplants with excellent outcomes. Duke introduced an on-table assessment technique for infant heart transplants, while Vanderbilt infused cold preservative solutions into donor hearts—all bypassing complex perfusion machinery
5. Broader Impact on Donor Availability
Experts estimate that using DCD hearts could increase the available donor heart pool by up to 30%—significantly reducing wait-list mortality. REUP and related methods provide accessible, scalable solutions for transplant centers without expensive equipment
📄 Timeline of Advancements
| Year | Milestone |
|---|---|
| 2015 | First adult DCD heart transplants performed in UK trials |
| 2019 | Duke University completes first U.S. reanimated DCD heart transplant |
| 2023 | NEJM publishes randomized trial comparing DCD perfusion vs. brain-death cold storage methods |
| 2025 | Vanderbilt and Duke deploy simplified, cost-effective REUP-like protocols in clinical use |
🧭 Why This Innovation Is Critical
- Larger Donor Pool: By safely using DCD hearts, REUP and similar methods dramatically expand donations.
- Cost‑Effective: The approach avoids the need for expensive perfusion machines, making it widely adoptable.
- Ethically Viable: It sidesteps concerns related to reanimating hearts inside the donor’s body, simplifying regulatory and ethical compliance.
- Broader Access: Early-stage results show potential for applications even in resource-limited settings, including pediatric cases.
