The number of heart transplants (HT) has been rising in the United States each year, with a record 3551 transplants performed in 2019. 1 Despite this, more than 3709 people continue to await HT, with waitlist times averaging months to years. Each year, 5%-10% of HT candidates die on the waitlist. 1 There has been an increase in the rate of hepatitis C virus-infected (HCV+) organs available for transplant. 2-4 Drug overdose deaths (ODD) are a large contributor, with the CDC reporting approximately 70 000 ODDs in 2017, of which 30% were estimated to be HCV+ donors. 3,5 ODD donors are usually younger, have less comorbid conditions, and are more likely to have died from anoxia, 3 factors associated with improved posttransplant survival. 6,7 Historically

Because extensive data from medical records are gathered by organ procurement teams, the process of data transfer between sites created a data security risk. This includes the use of fax machines, courier services, and employees’ vehicles. Even health records transmitted over public Wi-Fi become at risk for a data breach. The Plan-Do-Study-Act method for performance improvement was used to address this time-consuming and labor-intensive process. A secured virtual private network from within the donor hospital site setting was developed to improve the transfer of images and data. The goal was to improve the process and increase data security. Once the new network was in place, the process steps decreased and eliminated data vulnerability. Average process time decreased by approximately 1 hour. Organs procured increased from pre (expected 3, observed 2) to post (expected 3, observed 5) implementation of the new process.

As organ procurement organizations nationwide see an increased opportunity to retransplant already transplanted hearts, we would like to share the overview and process of our 2 successful cases. Heart retransplantation increased our cardiac placement rates by 2.64% and 2% in 2015 and 2019, respectively. Spread across a nation that sees over 3500 heart placements annually, a 2% increase would be substantial. Since 2009, our cases stand as the only documented heart retransplantations in the United States. However, United Network for Organ Sharing data shows that potential exists. From a facilitation perspective, we have developed a protocol to ease the matching process. From a surgical perspective, these cases had no complications and saved 2 lives, with each heart now beating in a third person. We hope that by sharing our process and success, we can familiarize fellow organ procurement organizations and transplant communities with this viable opportunity.

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