Alexander B, Javed H, Furrukh A, Joshi K, Steen L, Rajab TK. Innovative strategies to increase cardiac donor availability. World J Transplant 2025; 15(3): 102768 [DOI: 10.5500/wjt.v15.i3.102768]
Corresponding Author of This Article
Taufiek Konrad Rajab, MD, Assistant Professor, Department of Cardiothoracic Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, United States. tkrajab@uams.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2025; 15(3): 102768 Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.102768
Innovative strategies to increase cardiac donor availability
Benjamin Alexander, Herra Javed, Anshaal Furrukh, Krittika Joshi, Louis Steen, Taufiek Konrad Rajab
Benjamin Alexander, Herra Javed, Anshaal Furrukh, Louis Steen, Taufiek Konrad Rajab, Department of Cardiothoracic Surgery, Arkansas Children's Hospital, Little Rock, AR 72202, United States
Krittika Joshi, Department of Pediatric Cardiology, Arkansas Children's Hospital, Little Rock, AR 72202, United States
Author contributions: Alexander B contributed to writing–original draft, reviewing, and editing; Javed H, Furrukh A, Steen L, Joshi K contributed to writing–reviewing, and editing; Rajab TK contributed to supervision, writing–reviewing and editing.
Conflict-of-interest statement: The authors of this manuscript report no conflicts interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Taufiek Konrad Rajab, MD, Assistant Professor, Department of Cardiothoracic Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, United States. tkrajab@uams.edu
Received: October 30, 2024 Revised: February 10, 2025 Accepted: March 6, 2025 Published online: September 18, 2025 Processing time: 172 Days and 5 Hours
Abstract
Heart transplantation is a life-saving procedure for many people throughout the world. Data shows that in 2024, there was an increase in the volume of adult heart transplantation in the United States even as there was a decrease in the volume of pediatric heart transplantation to the lowest volume in a decade. Organ availability remains a major limiting factor affecting transplant volume. This mandates that innovation must take place to increase the supply of donor organs. While some strategies such as donation after cardiac death, hepatitis C virus + transplantation, and ABO-incompatible transplantation have increased the pool for donation, it still falls short of meeting the demand. Other proposed strategies include splitting the donor heart to provide multiple partial heart transplants, domino partial heart transplantation, changes in legislation including opt-out legislation, and xenotransplantation. Further evolution and refinement of these strategies will make a meaningful impact on patients awaiting life-saving heart transplants.
Core Tip: Heart transplantation is a procedure for extending the life of patients subject to heart failure but is limited in capacity by the availability of organ donations. Here we present a review on surgical, medical and policy innovations that can be used to increase the availability of donor organs for the general public.
