Doctors Eduardo Miñambres, from Marqués de Valdecilla University Hospital, and Mario Royo-Villanova, from Virgen de la Arrixaca University Hospital in Murcia, lead the study “Clinical Evidence of the Absence of Brain Perfusion During Thoraco-Abdominal Normothermic Regional Perfusion in Donation After Circulatory Determination of Death”, recently published in the scientific journal American Journal of Transplantation. The research involves professionals from both hospitals and from the Spanish National Transplant Organization (ONT).
The study unequivocally demonstrates that the use of extracorporeal devices applied to organ donors after circulatory determination of death is safe and ensures the absence of brain perfusion once the patient has died.
Brain perfusion refers to the passage of blood through the brain. According to the study results, there is no brain perfusion after these devices are applied to the deceased donor, providing robust clinical evidence of the procedure’s safety.
The authors note that the use of extracorporeal devices in organ donation—particularly in heart donation—has shown excellent outcomes, with improved organ utilization and recipient survival compared to conventional techniques. However, it is a highly complex procedure that requires advanced training and experience from donation teams.
The main novelty of the study is that, for the first time, it provides conclusive proof that cerebral circulation is completely excluded during the procedure once these devices are applied to the donor’s body. The involvement of Interventional Neuroradiology professionals from both centers was key: by using advanced neuroimaging techniques and intracranial pressure sensors, they contributed to establishing the unquestionable validity of this method. This finding may help expand a technique that currently accounts for 52% of donors in Spain and has increased the number of hearts available for transplantation by 40%, helping to reduce mortality among patients on waiting lists.
The study was presented in April at the World Congress on Heart and Lung Transplantation in Toronto and will be referenced in the upcoming European guidelines on donation after circulatory death, to be published shortly. Likewise, in November 2025, the Organ Procurement and Transplantation Network (OPTN) in the United States recommended the sectioning of the supra-aortic trunks, as described in the article, to ensure procedural safety.
