Transportation of Organs

*This blog pertains to the SNBAL readings on kidneys and organ transplantation and transportation. Last semester I was part of a team that wrote a business proposal for a organ transplant system. I wanted to share some things we learned about this developing LifeCradle technology. Students in our physiology class also on this team were Shannon Tovson and Katie Ramirez. *

Nearly one hundred thousand candidates are currently on waiting lists for organ transplants in the United States. Unfortunately, this number is increasing by approximately one hundred ten people each day. The immense number of people who need transplants presents a need for an improved preservation technique that will allow the long-distance procurement of donor organs. Current organ preservation techniques are only successful for limited distances, and as a result, thousands of organs go unused each year. This large number of unused organs is unacceptable when nearly twenty people per day die waiting for a transplant. Although recent years have seen tremendous advancements in medical technologies and surgical techniques, there have been no significant changes in the preservation and transportation of human organs. The LifeCradle^TM redefines human heart transplantation through better preservation and significant extension of the window of viability between procurement and completed transplant. It is a noteworthy improvement from the current method of placing a plastic bag with the heart and nutrient solution into a cooler-type container filled with ice. The LifeCradle^TM preserves the heart using cold-oxygenated perfusion of the organ with oxygen, electrolytes, and other nutrients. The new method extends the life of the transported organ up to six hundred percent, allowing more time to travel farther distances, find a matching recipient, and save thousands more lives.

LifeCradle^TM will be used to transport the hearts from their point of donation to a transplant center where they can be transplanted into a recipient. LifeCradle^TM offers oxygenation, continuous cold perfusion of an organ or tissue, at a controlled temperature, and uses AC or DC
power supply. The organ will be flushed with fluid continuously so that the heart will intentionally continue to beat, even as it is being sewn into the recipient. The organ or tissue will be oxygenated to ensure adequate oxygen supply since the organ or tissue will not have an adequate blood supply when outside the host and donors bodies. But with LifeCradle^TM, the organ will be sustained for a much longer period in ischemia than if it were just in an ice cooler. The power supply, in the form of four batteries, will ensure a controlled cold temperature setting so that the organ does not change its chemical and physical makeup.

LifeCradle^TM perfuses the heart with a fluid containing the oxygen, electrolytes, and special nutrients needed for preservation. These elements are all biocompatible; thus, their use on the organ will not increase the probability of recipient rejection upon transplantation of the donor organ, and there is little risk involved for the patient. By extending the amount of time an organ can spend outside of the body before transplantation, LifeCradle^TM could potentially increase the patient survival rate significantly. The current four to six hour timeframe that a transplantable organ can survive outside the body does not allow for adequate testing of donor-recipient compatibility. This increases the probability of rejection once the organ is implanted; however, if this time frame is extended by LifeCradle^TM, more thorough testing can be accomplished. The system itself is portable and poses no safety risk to the operator. The fluid needed for operation can be made readily available as well.

Although few patient risks exist with proper use of LifeCradle^TM, other risks can occur with misuse. The LifeCradle^TM environment is kept sterile and with proper precaution will remain this way for the duration of its use; however, as with any organ transportation and transplant, the contamination risk remains. Furthermore, the LifeCradle^TM has been proven to extend the organ’s life for up to twenty-four hours. If the transportation process exceeds this time limit, the organ could undergo irreparable damage causing dysfunction upon transplantation or complete necrosis. As with any medical device, the LifeCradle^TM has a recommended period of use. Any use beyond this specified time could result in ultimate transplant failure.

Inherent risks associated with organ transportation and transplantation should be considered as well. Such risk include donor-recipient mismatch resulting in rejection, organ dysfunction and organ necrosis. Presently, the largest risk is the delayed reception of a transplant. Receiving a transplant quickly increases the chance for successful transplant, and LifeCradle^TM will be a key factor in making a greater number of organs available to people in a broader range of places.

*This is written this way (will be, etc.) because the LifeCradle is a developing technology of Organ Transport Systems and right now is aimed specifically at heart transportation. A current technology on the market for kidney transport is marketed by Organ Recovery Systems.*

Since Organ Transport Systems specializes in preserving the heart, we do not currently face any direct competition. However, there is a company called Organ Recovery Systems that specializes in preserving the kidneys in transport. Their LifePort^TM Kidney Transporter perfuses a nutrient filled solution through the kidney during transport until the kidney is implanted into the recipient. In addition, this device displays key organ data in real time that will assist the surgeon in determining whether the organ is compatible and acceptible for transplant. In the future, Organ Recovery Systems plans to develop similar technology for heart, liver and pancreas transplants.

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Organ Procurement and Transplantation Network http://www.optn.org/

United Network for Organ Sharing http://www.unos.org/

Organ Recovery Systems http://www.organ-recovery.com/lifeport.html

Organ Transport Systems http://www.organtransportsystems.com/