signature: Valerie Goodwin
Newswise — In the United States, approximately 30 to 40 percent of donor hearts are ineligible for transplant due to insufficient donor function.
This reduces the number of donor hearts available to match those in need of a heart transplant.
Led by a team from the University of Michigan Health Sciences Alvaro Rojas Pena, MDA research scientist in the Department of Transplant Surgery at the University of Michigan Health School, for the past eight years he has been studying better ways to transport donor organs, particularly hearts, in order to increase the number of organs available for transplant.
Using a modified normothermic perfusion system, Rojas-Pena's team found they could preserve the heart for up to 24 hours.
The system is used to perfuse organs with a blood-derived solution and includes a blood filter to remove toxins.
This system allows for long-term storage beyond 12 hours without causing edema or organ damage.
The current standard for heart preservation from donation to transplant is a maximum of 6 hours of cold storage.
Although some hearts can be transplanted after six hours, post-transplant morbidity and mortality are increasing.
“Coronary blood perfusion can maintain cardiac viability, remove toxins and reduce tissue edema,” Rojas-Pena said.
“Most importantly, our system can be used to objectively assess organ function prior to transplant, including the ability to perform echocardiograms, in comparison to donor functional assessments.”
This study and the current data provide proof of concept that normothermic perfusion may increase the organ pool by considering hearts that would previously have been discarded, performing objective assessments of cardiac function, increasing the distance between donor and recipient, and developing cardiac-specific perfusion therapies.
Extending organ preservation reduces logistical issues and allows organs with marginal or questionable function to be objectively evaluated for potential transplantation.
This opens up options for pre-transplant “organ” treatment and conditioning.
Additional authors include Brianna L. Spencer, Spencer K. Wilhelm, Christopher Stephan, Kristopher A. Urrea, Daniela Pelaez Palacio and Robert H. Bartlett of the University of Michigan Medical School's Department of Surgery's Extracorporeal Biosupport Laboratory, and Daniel H. Drake of the University of Michigan Medical School's Department of Surgery's Extracorporeal Biosupport Laboratory and the University of Michigan Medical School's Department of Cardiac Surgery.
This research was funded by the Maxim and Stuart Frankel Foundation, Michigan Fast Forward, and current research through NIH R01-HL161139-02.
Michigan Research Core: ULAM Pathology Core (formerly IVAC)
Cited paper: “Extending cardiac preservation by 24 hours with normothermic perfusion” Frontiers in Cardiovascular Medicine Translation: 10.3389/fcvm.2024.1325169
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