Faster. Colder. Smarter: REUP and the New Era of DCD Heart Transplantation

🫀 Rethinking DCD Heart Transplantation   A new JAMA Original Investigation reports encouraging early outcomes using rapid recovery with extended ultraoxygenated preservation (REUP) for donation after circulatory death (DCD) heart transplantation—without donor heart reanimation or machine perfusion.   🔬 In a 24-patient case series, REUP achieved 96% 30-day survival, low primary graft dysfunction (4%), and minimal early rejection, even with older donors and prolonged ischemic times. ⚖️ By avoiding reanimation, REUP may reduce ethical concerns, cost, and logistical complexity, while expanding the usable donor pool. 🌍 A potentially scalable, globally relevant step forward in transplant medicine.   Sometimes progress is not about doing more—but about doing just enough, better.