Addressing the Donor Pool Shortage Through Innovation
With thousands of patients waiting for a heart transplant around the world, the demand for organs far exceeds the available supply. The authors highlight how each region has taken varied approaches to this issue, including the use of mechanical circulatory support systems, marginal donors, and hearts from donation after circulatory death (DCD) patients.
Recently, researchers have also explored using bioengineered hearts, mechanical devices, and xenotransplantation to address the donor organ shortage. All have had varying levels of success, but none have yet been able to replace a donated heart.
Technology is also transforming organ transport, helping to overcome the logistical challenges of time and distance. “By utilizing new technology, we can safely bridge greater distances between donor and recipient. This capability expands the donor pool and gives more of our patients at Stanford a chance at a new life,” said William Hiesinger, MD, Associate Professor of Cardiothoracic Surgery and Section Chief of Heart & Lung Transplantation and Mechanical Circulatory Support at Stanford.
In 2022, Stanford cardiothoracic surgeons developed and applied a method to transplant a beating heart, supported by an organ perfusion system machine, into the recipient. Many transplant programs around the country have now adopted this technique. The use of these organ preservation systems has the potential to allow worldwide sharing of organs, increasing the possibility of finding a match for recipients.
“Overcoming challenges such as donor shortages, geographic barriers, and regulatory inconsistencies will require a collective effort to ensure equitable access to life-saving therapies for all patients now and in the future,” said Dr. Chen.
The paper, “Adult Heart Transplantation in the USA and Western Europe: State of the Art Review,” was published in the European Heart Journal in November 2025.
