WASHINGTON (AP) — Most transplanted hearts are from donors who are brain dead, but new research shows a different approach can be just as successful and boost the number of available organs.

It’s called donation after circulatory death, a method long used to recover kidneys and other organs but not more fragile hearts. Duke Health researchers said Wednesday that using those long-shunned hearts could allow possibly thousands more patients a chance at a lifesaving transplant — expanding the number of donor hearts by 30%.

“Honestly if we could snap our fingers and just get people to use this, I think it probably would go up even more than that,” said transplant surgeon Dr. Jacob Schroder of Duke University School of Medicine, who led the research. “This really should be standard of care.”

The usual method of organ donation occurs when doctors, through careful testing, determine someone has no brain function after a catastrophic injury — meaning they’re brain-dead. The body is left on a ventilator that keeps the heart beating and organs oxygenated until they’re recovered and put on ice.

In contrast, donation after circulatory death occurs when someone has a nonsurvivable brain injury but, because all brain function hasn’t yet ceased, the family decides to withdraw life support and the heart stops. That means organs go without oxygen for a while before they can be recovered — and surgeons, worried the heart would be damaged, left it behind.

What’s changed: Now doctors can remove those hearts and put them in a machine that “reanimates” them, pumping through blood and nutrients as they’re transported –- and demonstrating if they work OK before the planned transplant.

Wednesday’s study, conducted at multiple hospitals around the country, involved 180 transplant recipients, half who received DCD hearts and half given hearts from brain-dead donors that were transported on ice.

Survival six months later was about the same –- 94% for the recipients of cardiac-death donations and 90% for those who got the usual hearts, the researchers reported in the New England Journal of Medicine.

The findings are exciting and show “the potential to increase fairness and equity in heart transplantation, allowing more persons with heart failure to have access to this lifesaving therapy,” transplant cardiologist Dr. Nancy Sweitzer of Washington University in St. Louis, who wasn’t involved with the study, wrote in an accompanying editorial.

Last year, 4,111 heart transplants were performed in the U.S., a record number but not nearly enough to meet the need. Hundreds of thousands of people suffer from advanced heart failure but many never are offered a transplant and still others die waiting for one.

Researchers in Australia and the U.K. first began trying DCD heart transplants about seven years ago. Duke pioneered the U.S. experiments in late 2019, one of about 20 U.S. hospitals now offering this method. Last year, there were 345 such heart transplants in the U.S., and 227 so far this year, according to the United Network for Organ Sharing.

In the Duke-led study, nearly 90% of the DCD hearts recovered wound up being transplanted, signaling that it’s worthwhile for more hospitals to start using the newer method.

Sweitzer noted that many would-be donors have severe brain injuries but don’t meet the criteria for brain death, meaning a lot of potentially usable hearts never get donated. But she also cautioned that there’s still more to learn, noting that the very sickest patients on the waiting list were less likely to receive DCD hearts in the study.

Schroder said most who received DCD hearts already had implanted heart pumps that made the transplant more difficult to perform, even if they weren’t ranked as high on the waiting list.

The study was funded by TransMedics, which makes the heart storage system.

NEW YORK (AP) — After a trio of new announcements this week, the Republican Party’s 2024 presidential field is all but set.

A handful of stragglers may jump in later, but as of now there are at least 10 high-profile Republican candidates officially seeking their party’s nomination. And with the announcement phase of the primary campaign largely over, several leading Republican contenders will gather in North Carolina this weekend to begin a more aggressive sorting period.

It will be a long road to the GOP’s national convention in Milwaukee next summer when Republican delegates across the country gather to finalize their nominee to run against President Joe Biden. Surprises are guaranteed. Fortunes will change. But as of now, every Republican White House hopeful is looking up at former President Donald Trump, who is the undisputed frontrunner in the crowded contest.

Here are some takeaways on where the Republican contest stands:

IT’S A LARGE FIELD AFTER ALL

Trump launched his campaign nearly seven months ago in an effort to scare off potential challengers. It didn’t work.

As of now, the former president is running in a field that features no fewer than nine high-profile challengers. They include Mike Pence, a former vice president; four current or former governors: Florida Gov. Ron DeSantis, North Dakota Gov. Doug Burgum, former New Jersey Gov. Chris Christie and former Arkansas Gov. Asa Hutchinson; Nikki Haley, the former ambassador to the United Nations and also a former South Carolina governor; U.S. Sen. Tim Scott of South Carolina; biotech entrepreneur Vivek Ramaswamy; and conservative talk show host Larry Elder, an unsuccessful candidate for California governor.

While big, the 2024 field could have been much bigger. The party’s 2016 class featured 17 candidates that filled two debate stages.

Several Republicans who had taken steps to prepare for a run in 2024 ultimately bowed out. They include former Secretary of State Mike Pompeo, New Hampshire Gov. Chris Sununu, former Maryland Gov. Larry Hogan, Texas Sen. Ted Cruz and Arkansas Sen. Tom Cotton.

Meanwhile, a handful of higher-profile Republicans are still considering a run, including former Energy Secretary Rick Perry, Miami Mayor Francis Suarez and Virginia Gov. Glenn Youngkin.

IT’S TRUMP AND EVERYONE ELSE

Make no mistake: This is Trump’s race to lose.

The former president is dominating early primary polls, despite his extraordinary legal troubles, his continued lies about the 2020 election that fueled the Jan. 6 insurrection, and serious concerns among GOP officials about his ability to win the general election. Trump nonetheless maintains a strong grip on a significant portion of the Republican base that has yet to fall in love with an alternative.

DeSantis is Trump’s strongest rival on paper, but the Florida governor has yet to outline a clear path to victory. The Florida governor is trying to out-Trump Trump by taking a harder line on immigration, abortion and other policies that tear at the nation’s divides, while embracing the former president’s combative style and mannerisms.

Meanwhile, Trump’s team is thrilled about the sheer quantity of candidates in the race, which create a math problem that benefits Trump. It looks like 2016 all over again, when Trump won the New Hampshire primary with only 35% of the vote because the other candidates chopped up the rest of the vote.

Trump’s Republican critics warned against this exact scenario over the last year, but for now, they seem incapable of stopping it.

NO CLEAR STRATEGY TO TAKE DOWN TRUMP

Math aside, Trump’s Republican rivals have yet to figure out a consistent strategy to take him down. That’s not to say they haven’t begun to try.

Pence told Iowa voters this week that Trump “demanded I choose between him and the Constitution,” a reference to Trump’s oft-repeated — and false — insistence that Pence had the authority to overturn the 2020 election. Pence called Trump’s words “reckless” and said the former president endangered his family.

DeSantis, like others, has dropped many indirect jabs at Trump, focused largely on the former president’s inability to serve more than one term and the GOP’s “culture of losing” under his leadership since 2016. DeSantis’ team also thinks they have an opportunity to out-flank Trump from the right on conservative priorities like abortion and immigration.

DeSantis shrugged off Trump’s large polling advantage when asked this week in Arizona: “You don’t do a poll a year out and say that’s how the election runs out,” he said.

Christie may be the most vocal Trump critic in the race, although he hasn’t held office in more than five years.

“I’m going out there to take out Donald Trump,” the former New Jersey governor told New Hampshire voters this week. “But here’s why: I want to win, and I don’t want him to win. … There is one lane to the Republican nomination and he’s in front of it.”

Expect to see anti-Trump strategies continue to evolve this weekend in North Carolina.

A DIVERSE FIELD

The 2024 Republican field equals the GOP’s 2016 class as the most racially diverse in the party’s long history.

At least four candidates of color are seeking the presidency this year: Scott and Elder are Black, while Haley and Ramaswamy are of Indian descent. For Haley and Scott in particular, race plays a central role in their pitch to voters, although all four deny the existence of systemic racism and largely oppose federal policies designed to help people based on the color of their skin.

Republican officials are hopeful that the diverse field will help the party continue its modest progress with Black voters and Latinos. Both groups still overwhelmingly support Democrats, but even small cracks in the Democratic coalition could be significant in 2024.

There is just one woman in Republican field. But there is strong diversity in the ages of the candidates: Trump is the oldest at 76, while Ramaswamy is the youngest at 37. DeSantis is just 44, while Haley and Scott are in their 50s. The rest of the candidates are in their 60s and 70s.

RIGHT ON POLICY

With few exceptions, the Republican field has embraced hardline conservative policies on issues like abortion, immigration, gun violence and LGBTQ rights.

All of the candidates oppose abortion rights to some extent, although there are differences in the degree of their opposition and their rhetoric on the procedure. Pence and Scott have openly endorsed national abortion bans, while Trump and DeSantis have avoided taking a firm position on a federal ban so far. That said, DeSantis this spring signed into Florida law a ban on abortions at six weeks of pregnancy, one of the nation’s most restrictive policies.

The entire Republican field also opposes new limits on gun ownership, including an assault weapons ban. Most blame the nation’s gun violence epidemic on mental health issues. DeSantis this spring enacted a new law that allows Florida residents to carry concealed firearms without a permit.

The Republican field has also embraced the party’s recent focus on the LGBTQ community.

Haley mocked and misgendered transgender women on the campaign trail in recent weeks. Trump and DeSantis have decried gender-affirming surgeries for minors as child abuse. And Scott co-sponsored a Senate bill that would cut funding for elementary or middle schools that change a student’s pronouns without first obtaining parental consent.

There appears to be some disagreement on Social Security and Medicare, however.

DeSantis, as a member of Congress, voted for a resolution that would have raised the age to qualify for Medicare and Social Security to 70. He seems to have moved away from that position since becoming the Florida governor. But Trump has seized on his rival’s past position, while vowing to preserve the popular programs.

UNCERTAINTY LOOMS

The Republican field may be settling, but major surprises in the months ahead are virtually guaranteed.

Trump’s legal problems may loom largest. The former president is already facing 34 felony counts of falsifying business records related to hush-money payments made during the 2016 campaign to bury allegations that he had extramarital sexual encounters. Federal prosecutors are also currently using grand juries in Washington and Florida as part of their investigation into the possible mishandling of classified documents. And prosecutors in Georgia are investigating whether Trump broke the law while trying to overturn his 2020 election loss.

At the same time, DeSantis has only begun to be vetted on the national stage. Opponents in both parties are poring through his background for any sign of damaging information. Republican colleagues openly question his interpersonal skills. And he’s quick to tangle with the media in unscripted moments on the campaign trail.

Meanwhile, major uncertainty hangs over upcoming presidential debates, which are scheduled to begin in late August. Trump, who holds a big lead in early polls, has raised the possibility of skipping the debates altogether. DeSantis has lashed out at mainstream media outlets that would play a role in hosting the televised events. And it’s unclear whether lower-tier candidates could meet the relatively modest polling and fundraising thresholds.