In a historic moment for Canadian medicine, Toronto General Hospital has successfully performed Canada’s first heart transplant using a donor heart that had stopped beating, the University Health Network (UHN) announced this week.
The groundbreaking procedure, conducted in early September, marks the country’s first use of a donation-after-circulatory-death (DCC) heart — a medical milestone that could dramatically increase the availability of donor organs for patients suffering from advanced heart failure.
Traditionally, heart donations have only been taken from patients who are brain-dead but whose hearts continue to beat. In contrast, the DCC method allows surgeons to recover a heart that briefly stopped beating after the withdrawal of life support — before carefully restoring and transplanting it.
“These hearts experience a short period without oxygen,” said the UHN team, “but medical advances now allow them to be successfully transplanted under strict clinical criteria.”
A Lifeline for Patients Awaiting Transplants
Cardiac surgeon Dr. Seyed Alireza Rabi, who led the pioneering surgery, said the patient is recovering well and that the success of this transplant could increase Canada’s donor heart pool by up to 30 per cent.
“Many advanced heart failure patients never make it to the waitlist,” Rabi said. “A significant number die while waiting for precious organs. This process opens the door for more patients to live.”
The procedure, already practiced in Australia (since 2014), the United Kingdom (since 2015), and the United States (since 2019), was brought to Canada after extensive study of global outcomes. Data from those countries show strong post-transplant recovery rates and long-term success.
Precision and Timing: The Critical Windows
The DCC transplant process involves two highly sensitive time frames:
The “warm period”, immediately after the donor’s heart stops, when it is removed and revived.
The “cold period”, when the heart is preserved in chilled solution for transport and implantation.
Dr. Rabi emphasized that minimizing damage during these intervals is vital. “Every minute matters,” he said. “We must ensure oxygen delivery, temperature control, and precise timing to protect the heart before it reaches the recipient.”
Transforming the Future of Transplant Surgery
The University Health Network, which oversees Toronto General Hospital, called the operation a “major advance in transplant surgery” and a testament to Canada’s growing capacity for complex procedures.
“This is more than a medical success,” said Dr. Thomas Forbes, Surgeon-in-Chief at UHN. “It’s a milestone that gives Canadians with late-stage heart failure new hope — a chance at a longer, healthier life.”
Health Minister Sylvia Jones praised the medical team, saying, “The first DCC transplant in Canada demonstrates how innovation and collaboration can save more lives.”
The Bigger Picture
According to data from the Canadian Institute for Health Information, 155 adults and 29 children were waiting for heart transplants at the end of 2024. With donor shortages long posing a major barrier, the DCC process could significantly shorten wait times and prevent unnecessary deaths.
End-stage heart failure remains a fatal condition, with transplant surgery the only definitive cure. For the UHN team and patients across the country, this breakthrough represents not just a technical victory — but the revival of hope itself.
