Traditionally, heart donors are people with no brain function whose hearts continue to beat as organs are recovered. In the DCC approach, the heart is retrieved from someone who has died, even though the heart has experienced a brief period without oxygen. Advances in medical technology now allow these hearts to be transplanted under carefully defined criteria.
Donors for the DCC process are individuals with no chance of neurological recovery who have not been declared brain dead by a neurologist. Life support is withdrawn with the patient’s wishes or their family’s consent, and the heart is removed once death is confirmed.
The recipient is recovering very well, and this achievement is described as opening the door for more patients in need of a life-saving transplant. Dr. Seyed Alireza Rabi, a cardiac surgeon on the transplantation team, notes that many advanced heart failure patients never reach the waitlist, and a significant number die while awaiting donor hearts. He emphasizes that heart transplantation remains the only cure for advanced heart failure.
Data show there were 155 adults and 29 children in Canada waiting for heart transplants at the end of 2024, underscoring the potential impact of expanding the donor pool.
The procedure is expected to increase the heart donor pool by about 30 percent. While DCC is not new globally—Australia has performed such transplants since 2014, the United Kingdom since 2015, and the United States since 2019—the Toronto case marks Canada’s first use of this approach for a heart.
Two critical moments define the process: the warm period shortly after donor death during which the heart is non-beating and prepared for removal, and the cold period when the heart is preserved in a cold solution for transport to the recipient. Reducing damage to the heart and minimizing the time from donor to recipient are essential to successful transplantation.
Canonically, DCC has been used in Canada for lung, kidney, and liver transplants, but this marks the first time it has been used for a heart in the country. Dr. Thomas Forbes, surgeon in chief at Toronto General Hospital, calls the development a major advance in transplant surgery that could broaden access for Canadians with late-stage heart failure. He notes end-stage heart failure is debilitating and fatal without a transplant, and that increasing donor availability could extend and improve patients’ lives, allowing them to engage with family and friends again.
Ontario’s health minister, Sylvia Jones, congratulated the team on what she described as a historic milestone in Canadian healthcare, saying that the first DCC transplant in Canada performed in Ontario demonstrates how innovation and collaboration can save more lives.
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