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Canada’s first ‘death by circulatory criteria’ heart transplant achieved at Toronto General Hospital

Innovation | Donors

Heart Transplantation: Donation After Circulatory Death
Emerging Frontier in Heart Transplantation: Donation After Circulatory Death [American College of Cardiology]
CANADIAN NATIONAL NEWS & ANALYSIS

Wednesday October 8, 2025 | TORONTO, ON

by Mary P Brooke, B.Sc. | Island Social Trends


In September, a donated human heart that had stopped beating was successfully transplanted into a human recipient — a medical first.

University Health Network (UHN) released the news today.

A UHN multidisciplinary team Dr. Seyed Alireza Rabi performed the first Canadian death by circulatory criteria (DCC) heart transplant.

The successful procedure was performed at UHN’s Toronto General Hospital. The DCC heart transplant recipient is recovering well, says UHN.

Heart Transplantation: Donation After Circulatory Death
Emerging Frontier in Heart Transplantation: Donation After Circulatory Death [American College of Cardiology]

The procedure is a milestone in the field of heart transplantation and sets the stage to save many more lives in Canada. The procedure was first used in Australia about 10 years ago.

Increasing the donor pool:

DCC is forecast to increase the heart donor pool in Canada by 30 per cent. At the end of 2024, there were 155 adults and 29 children in Canada waiting for heart transplants, according to data collected by the Canadian Institute for Health Information (CIHI).

Heart failure is the most common reason for admission to hospital in Canada, and is a leading cause of death.

Heart disease is primarily caused by a buildup of plaque in the arteries (atherosclerosis) from risk factors such as high blood pressure, high cholesterol, diabetes, smoking, and an unhealthy lifestyle including poor diet, alcohol intake and lack of exercise.

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Traditionally a donated heart is still beating:

Traditionally, heart transplants have only been possible from donors where the brain has permanently ceased to function, while the heart continues to beat.

By contrast, DCC involves patients who have no chance of neurological recovery, but do not meet the criteria for brain death as confirmed by an independent neurologist.

In accordance with the patient’s wishes, or his or her family’s wishes, life support is withdrawn. After the heart stops beating and death is confirmed, organs are promptly recovered. Although these hearts experience a brief period without oxygen, advances in medical technology now allow them to be successfully transplanted under carefully defined criteria, said UHN in their news release today.

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About the surgeon:

Dr. Seyed Alireza Rabi, cardiac surgeon at UHN’s Peter Munk Cardiac Centre, led the multidisciplinary transplantation along with Dr. Michael McDonald’s team of cardiologists. Dr. Rabi previously was part of the team that performed one of the first DCC heart transplantations in the U.S. at Massachusetts General Hospital in 2019.

heart transplant surgeon, UHN
Dr. Seyed Alireza Rabi of the University Health Network in Toronto, Ontario. [UHN]

“UHN is a Canadian and global leader for cardiac care and transplantation,” said Dr. Rabi. “Heart transplantation is the only cure for advanced heart failure. Many advanced heart failure patients never make it to the waitlist, and a significant number of those who do succumb to their disease while awaiting precious organs. Donation after circulatory death opens the door to more opportunities for patients waiting for a life-saving transplant.”

Donor support:

“The first DCC transplant in Canada performed right here in Ontario demonstrates how innovation and collaboration can save more lives. Our government, through the Trillium Gift of Life Network, is proud to support initiatives that expand access to organ donation and transplantation, ensuring that more Ontarians and Canadians receive the life-saving care they need,” said Ontario’s Deputy Premier and Minister of Health, Sylvia Jones. “Congratulations to the team at University Health Network on this Canadian-first and historic milestone in Canadian healthcare.”

Community support is essential to helping bring doctors like Dr. Rabi to UHN to innovate in surgery and help more patients receive the life-saving transplants they desperately need.

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Innovation:

“This transplantation reflects the dedication and expertise of our world-leading surgical teams, and our commitment to delivering the most innovative and effective care for patients,” said Dr. Thomas Forbes, UHN’s Surgeon-in-Chief.

“The successful completion of Canada’s first DCC heart transplant is a testament to the extraordinary skill and dedication of our cardiac and transplant teams. At the Peter Munk Cardiac Centre, we are proud to be at the forefront of surgical innovation that improves outcomes and expands access to care for patients across the country,” said Dr. Barry Rubin, Director of UHN’s Peter Munk Cardiac Centre.

Dr. Deepali Kumar, UHN’s Ajmera Transplant Centre Director, said “this achievement marks a turning point in heart transplantation in Canada. It reflects the innovation and collaboration that define the Ajmera Transplant Centre and our commitment to advancing transplant medicine.”

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