Promise of greater availability of hearts for the over 3,300 people waiting for transplants. Traditionally, in the United States, hearts for transplantation are donated after brain death. Beginning in 2019, surgeons began performing a small number of transplants using hearts donated after cardiac death (when the heart stops on its own or when life support is discontinued) that were reanimated, preserved, and assessed using an extracorporeal perfusion and preservation system. Now, a randomized controlled trial in the June 8 New England Journal of Medicine has found no difference in six-month survival rates between patients who received a heart donated after circulatory death (93%) and patients who received a heart donated after brain death (90%) as well as a similar number of serious adverse events at 30 days posttransplant (0.2 versus 0.1). The authors note that the results of this trial are short term and five-year follow-up is needed to determine long-term outcomes.