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Jonathan Alvin Wiryaputra

 

Jonathan Alvin Wiryaputra

National Cardiovascular Center,
Indonesia

Abstract Title: Expanding Donor Utilization in Heart Transplantation: Contemporary Outcomes of DCD and Normothermic Machine Perfusion

Biography:

Jonathan Alvin Wiryaputra, MD, is a physician based in Jakarta, Indonesia, affiliated with Rumah Sakit Pondok Indah Group. He has clinical experience in emergency and inpatient care, along with involvement in research coordination. His primary interests include cardiothoracic surgery, heart transplantation, and perioperative critical care. He is actively preparing for international clinical training and research collaborations, focusing on donor optimization, transplant outcomes, and surgical innovation in cardiovascular medicine.

Research Interest:

Background: Donor organ shortage remains the principal limitation in heart transplantation (HTx). Donation after circulatory death (DCD) and normothermic machine perfusion (NMP) have emerged as contemporary strategies to expand the donor pool while maintaining graft viability. This study evaluates recent clinical outcomes associated with these approaches.

Methods: A systematic review of studies published between 2020 and 2025 was conducted using PubMed, Embase, and Cochrane databases. Studies reporting outcomes of DCD HTx and/or NMP utilization were included. Primary endpoints were 30-day mortality and primary graft dysfunction (PGD). Secondary endpoints included 1-year survival and acute rejection rates.

Results: Fourteen studies comprising 2,018 HTx recipients were included, with 524 undergoing DCD transplantation. No significant difference was observed in 30-day mortality between DCD and donation after brain death (DBD) recipients (4.6% vs. 4.4%, p=0.81). Severe PGD incidence was comparable (8.9% vs. 8.5%, p=0.67), as were 1-year survival rates (88.7% vs. 89.5%, p=0.58). Among studies utilizing NMP (n=9), graft utilization increased by 15–25%, with a 30–40% reduction in cold ischemic time and improved early graft function in marginal donors.

Conclusion: DCD HTx supported by NMP demonstrates non-inferior short-term outcomes compared to DBD transplantation while significantly expanding donor availability. Broader adoption may help address persistent organ shortages in HTx.