**Canada's First Heart Transplant from Non-Heart-Beating Donor** Toronto General Hospital achieved a significant medical milestone in early September by performing Canada's first heart transplant from a donor whose heart had stopped beating. This groundbreaking procedure marks a shift from traditional heart transplants, which typically rely on brain-dead donors whose hearts continue to receive oxygen. The new method, known as death by circulatory criteria (DCC), is applicable to patients who have no chance of neurological recovery. After obtaining permission from the family, life support is withdrawn, the heart stops beating, and death is confirmed before organ recovery begins. Dr. Seyed Alireza Rabi, who led the multidisciplinary team at the University Health Network, explained the difference between the two methods. "In the old way in the brain-dead donor, the brain is dead, the heart is still beating. In the new way, both the heart and the brain have stopped working by the time we take the heart," he said. Despite the brief period without oxygen, advancements in medical technology have made it possible to successfully transplant these hearts. Dr. Rabi noted that similar procedures have been conducted in other countries, starting in Australia in 2014, followed by the U.K. in 2015 and the U.S. in 2019. He mentioned that while Canada still lacks some of the technologies used elsewhere, recent developments have allowed for the adoption of techniques to protect and preserve the heart. The DCC method is expected to increase the heart donor pool by 30%. Dr. Rabi stated, "We expect there will be 30% more heart transplants, donations using this technique. Data from other countries show increases in donations by 20 to 40%. It’s very significant." As of the end of 2024, there were 155 adults and 29 children on the waiting list for heart transplants in Canada, according to the Canadian Institute for Health Information. Dr. Rabi estimated that the wait time for a heart transplant is currently about 12 to 18 months, depending on blood type. He also highlighted the positive impact of DCC on mortality rates among those waiting for transplants. "The other countries also decreased their mortality on wait lists significantly — so people who are waiting and are sick and are going to die if they don’t get a heart," he said. Dr. Rabi emphasized that the long-term outcomes for DCC heart transplant recipients are comparable to those of traditional transplants, citing data from Australia. "We know that the long term of these hearts is the same as the traditional way. So we’re not jeopardizing the recipient," he added. Heart failure is a leading cause of hospitalization and death in Canada, and Dr. Rabi noted that heart transplants are the only cure for this condition. The first recipient of a DCC heart transplant in Toronto is recovering well, and more patients have since undergone the procedure. Dr. Rabi expressed gratitude to families who choose to donate their loved ones' organs during such difficult times, stating, "This is the worst time of their lives. So while they’re grieving their loved ones, they allow us to do our due diligence to make sure that heart is good. That’s really the only reason we can do this."