Randomised controlled trial

Transplantation Outcomes with Donor Hearts after Circulatory Death

N Engl J MedPublished

  • Randomised controlled trial
  • non-inferiority
  • 3:1 randomisation

Authors' conclusion

In this trial, risk-adjusted survival at 6 months after transplantation with a donor heart that had been reanimated and assessed with the use of extracorporeal nonischemic perfusion after circulatory death was not inferior to that after standard-care transplantation with a donor heart that had been preserved with the use of cold storage after brain death.

Study context

Population
Adult candidates for heart transplantation166 in as-treated analysis
Participants
180 candidates
Comparison
Donor hearts after circulatory death vs after brain death
Primary endpoint
Risk-adjusted survival (as-treated)
Follow-up
6 months

Primary result

Risk-adjusted survival

Least-squares mean difference

−3 percentage points

90% CI −10 to 3

P < 0.001 for non-inferiority

By group

Circulatory death vs Brain death
least-squares mean difference −3 percentage points (90% CI −10 to 3); P for non-inferiority < 0.001

Non-inferiority margin 20 as printed, not drawn

As reported in the abstract

Safety

Serious adverse events associated with the heart graft (mean per patient) · 30 days after transplantation

No substantial between-group differences
  • primary safety end point

Original publication

Transplantation Outcomes with Donor Hearts after Circulatory Death. N Engl J Med. Published 8 June 2023. doi:10.1056/nejmoa2212438

Summarised from the published abstract; every number is checked against it