The Use of Marginal Donor Hearts as an Effective Way to Expand the Donor Pool in Heart Transplantation

DOI: https://doi.org/10.63181/2788-4740.4.1.2026.29-47
Keywords: heart transplantation, marginal organs, donor organ, artificial circulation

Abstract

Introduction. The critical shortage of donor organs is the main problem in the world to provide for a need treatment of patients with terminal heart disease. One of the ways to expand the donor pool may be to expand the criteria for selecting donor hearts using the so-called "marginal donors". 

The aim of our study was to analyze the early and long-term results of using hearts from marginal donors in orthotopic heart transplantation in patients with terminal stage chronic heart failure.

Materials and methods. From December 2019 to October 2024, the heart transplantation team of the State Institution "Heart Institute of the Ministry of Health of Ukraine" performed 106 heart transplantations. In 39 (36.7%) cases, we used hearts from "marginal" donors for orthotopic heart transplantation, in 67 cases, orthotopic heart transplantation from classical donors was performed.

Results. The criteria for donor marginality were the need for regional normothermic perfusion, the ratio between the mass of the donor and the recipient <0.8, the presence of concomitant cardiosurgical pathology of the donor organ (the need for revascularization, correction of valvular defect), prolonged ischemia time of the donor organ more than
240 min., ABO incompatibility, the presence of congenital heart disease. Orthotopic heart transplantation from marginal donors provided results comparable in both the early and long-term to those of standard donor hearts.

Conclusions. The use of marginal donor hearts does not significantly affect the long-term outcomes of heart transplantation, which allows for a significant expansion of the donor pool, especially for patients with high status on the waiting list.

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Published
2026-04-13
How to Cite
Chaikovska, S., Todurov, B., Kovtun, G., Taranov, M., Kuzmych, I., Romanenko, S., Shevchenko, V., Todurov, M., Maruniak, S., & Sudakevych, S. (2026). The Use of Marginal Donor Hearts as an Effective Way to Expand the Donor Pool in Heart Transplantation . Transplantation and Artificial Organs, 4(1-2), 29-47. https://doi.org/10.63181/2788-4740.4.1.2026.29-47
Issue
Vol 4 No 1-2 (2026): Transplantation and artificial organs
Section
ARTICLES