New technique better preserves organs for transplant

Last year alone, more than 6,000 patients died while waiting for a transplant.

Preserving organs on ice prior to transplantation has been the standard for 20 years.

But now doctors have created a new technique that could help save more organs and more lives.

Ellen Litinger battled with breast cancer seven years ago, followed by a uterine cancer diagnosis. She thought the war was over, but right before grandson Jason was born, she found out she needed a new liver.

"It was just one thing after another and after that I really started to go downhill,” she said.

"She became more and more upset, somewhat depressed; you start to lose everything you had in your life,” Ellen’s husband Neil said.

Research by New York Presbyterian's Dr. James Guarrera is helping people like Ellen start living

Liver preservation times are short, under 12 hours. A technique called hypothermic machine perfusion is preserving donor livers in a new way.

"The technique really allows the organ to be healthier, to function more rapidly,” Dr. Guarrera said.

Data of the study suggests this technique can increase the time safely by at least 50 percent and possibly even double it in the future. It works like a dialysis machine for kidneys. Doctors connect special tubing to the artery and vein of the liver, while a mini cardiopulmonary bypass pump keeps circulation going. Unlike cold storage, HMP simulates liver function in the body by providing a continuous flow of oxygen and key nutrients.

"In the cold storage we put the organ in a cooler, all the waste products build up and are not circulated out and neutralized by the medications that we have in our solution that we also developed with the machine,” Dr. Guarrera said.

Thanks to a donor, and HMP, Ellen is back on her feet and back to spending time with the people who matter most.

Currently, more than 17,000 people in the U.S. are waiting for liver transplants.

So far, Dr. Guarrera has successfully transplanted 40 livers with this method.

The last 20 had been rejected by other transplant centers.

He hopes this technology will help expand the donor pool and save lives of people on the transplant list.

Research Summary:
REPORT: MB #3328

BACKGROUND: Enough people to populate a small city need an organ transplant to save their lives. That's more than 100,000 people. About 17 people every day die waiting for an organ, and about one-fourth of the people on the waiting list will not receive an organ. One donor could improve the lives of 50 people waiting on an organ. Organ donors can be of any age and health, but children under 18 have to have parental consent in order to donate. In order for organs to be transplanted from the body of a deceased person to the patient in need, the organs must be removed within 60 minutes, which can sometimes be an issue. A major issue with organ transplant is the donor banks because they typically do not have the ability to store organs for any significant length of time.
(SOURCE: Christus Hospital)

STANDARD ORGAN PRESERVATION: The standard means of preserving a soon-to-be transplanted organ is via cold storage. Cold storage first flushes the organ with a cleansing fluid immediately after removal from the donor body, and the fluid remains in the organ until transplanted. The organ is then placed in hypothermic storage to be transported to the organ recipient. While in hypothermic storage, many of the wastes build up because they are not being circulated by the blood.

HYPOTHERMIC MACHINE PERFUSION: Hypothermic machine perfusion is a new organ storage device that offers advantages over traditional cold storage. It protects better against cold ischemia, inadequate blood supply for too long. Hypothermic machine perfusion also allows for the organ to be preserved longer, perform quicker, and be healthier than one preserved with cold storage. Doctors connect a metal hose to the vein and artery of an organ. That keeps blood circulation going, allowing for the organ to get oxygen and nutrients. This method will hopefully allow for the donor pool to be expanded and transplants to be more successful.
(SOURCE: Transplantation Proceedings)

Wade Bryan Dotson
Director, Media Relations
NewYork-Presbyterian Hospital/Columbia
(212) 305-5587

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