**Title: Toronto Hospital Achieves First Heart Transplant After Circulatory Death** Surgeons at Toronto's University Health Network (UHN) have made history by performing Canada's first heart transplant using a donor whose heart had stopped beating. This groundbreaking procedure, known as donation after circulatory death (DCC), took place in early September at Toronto General Hospital. Traditionally, heart transplants are conducted using organs from brain-dead donors whose hearts continue to beat. In contrast, the DCC method involves recovering hearts after life support is withdrawn and death is confirmed. Dr. Ali Rabi, a cardiac surgeon at UHN's Peter Munk Cardiac Centre, led the surgical team. He explained, "Before, we only used hearts from brain-dead donors whose hearts were still beating. Now, we can use hearts that have stopped beating after life support is withdrawn." This innovative approach is expected to significantly increase the number of available hearts for transplant. According to UHN, the DCC process allows for the recovery of hearts from donors who are not considered brain dead but have no chance of neurological recovery. The decision to withdraw life support is made collaboratively by the patient, their family, and the medical team, including neurologists. Once death is confirmed, the heart is promptly removed for transplantation. Dr. Rabi noted that this new technique could increase the number of heart transplants by 20 to 40 percent, potentially saving lives for those waiting for a transplant. Heart failure is a leading cause of hospitalization in Canada, with 155 adults and 29 children on the waiting list for heart transplants as of the end of 2024. "These advancements in medical technology allow us to perform transplants shortly after the heart has stopped beating," Dr. Rabi said. He emphasized the importance of acting quickly, as the heart can deteriorate rapidly without a supply of oxygenated blood. After the heart is removed, it is placed in a specialized container that keeps it cooled and flushed with a protective solution. The heart can remain viable for up to an hour before transplantation. Once it arrives at its destination, it is connected to a perfusion machine that supplies it with blood, nutrients, and oxygen. Dr. Sam Shemie, medical director of the pediatric intensive care unit at the Montreal Children’s Hospital, explained, "The longer the time, the less likely the organ can restart or work again." The successful DCC heart transplant in Toronto follows a similar operation performed in Canada in 2024, although that procedure utilized a different method. Ontario's Deputy Premier and Minister of Health, Sylvia Jones, praised the achievement, stating, "This breakthrough shows how innovation can save more lives. Congratulations to UHN for this historic milestone." Dr. Rabi also acknowledged the generosity of donor families, saying, "It’s the hardest day of their lives, but many find comfort knowing their loved one helped save others." Recent studies from Australia and the U.S. indicate that recipients of DCC hearts have similar long-term survival rates as those who receive hearts from traditional brain-dead donors. Dr. Rabi encouraged young people to consider careers in heart failure and transplantation, predicting significant advancements in the field in the coming years.