Boston, MA April 10, 2008 – Data from experimental work on the use of organs from cardiac arrested donors will be presented this week at the International Society for Heart and Lung Transplantation’s 28th Annual Meeting and Scientific Sessions. Utilizing donors after cardiac death (DCD), also known as non-heart-beating donors (NHBDs) has the potential to overcome a critical shortage of suitable donor organs for lung, and possibly heart, transplantation.
In addition, strategies for organ preservation during transport from donor to recipient will be a primary topic of discussion at the ISHLT meeting running through Saturday at the Boston Marriott Copley Place and Hynes Convention Center.
“There is a worldwide shortage of quality donor organs for transplantation. This year, we are going to hear about clinical updates on non-heart-beating lung donors, and also exciting new experimental work on the possible use of hearts from cardiac-arrested donors,” said Steven Tsui, M.D., F.R.C.S., Director of Transplantation and Surgeon, Papworth Hospital, U.K. “In addition, there has been a lot of interest in techniques aiming to maintain, and possibly improve, donor organ function once they have been removed from the donor.”
NON-HEART-BEATING DONORS
Organ transplantation is currently limited by a shortage of suitable donors, which results in longer waiting times for patients and a substantial risk of dying before transplantation.
Promising research results suggest the potential to immediately increase the number of lungs available for transplantation. Although thousands of patients are on lung transplant waiting lists around the world, only a small percentage actually receive transplants. And likewise, a small proportion of individuals identified as organ donors actually have suitable lungs for transplantation.
During the ISHLT mini-oral session I: The Non-Heart Beating Donor for Heart Transplantation, Ayyaz Ali, F.R.C.S., Transplant Fellow from Papworth, will provide a report regarding the potential for resuscitating donor hearts from NHBDs using extracorporeal perfusion, which in turn could mean a larger portion of donor hearts being used to transplant patients who need them (Abstract #143).
RE-CONDITIONING DONOR ORGANS
Donor organs tend to deteriorate with time after brain-stem death. They may suffer further injury during transport to the recipient hospital. From time-to-time, their function declines so much that they can no longer be transplanted safely. It may be possible to maintain donor organs in a more healthy state during transport or even improve their function to make transplantation safer.
“Recently introduced concepts such as various Ex-Vivo Lung Perfusion (EVLP) techniques will be discussed during the Meeting. Likewise, clinical experience of the innovative Organ Care System (OCS) for donor hearts will be reported,” said Dr. Tsui.
The cold preservation method, which has been in practice for more than 25 years, delivers the organ in a non-functioning state immersed in a cold solution for preservation during transport. The time during transport in this method is referred to as cold ischemic time, more specifically the interval beginning when an organ is removed from the donor and is cooled with the solution, to the time when the organ is implanted.
Conversely, the Organ Care System (OCS) is based on warm blood perfusion technology, which it uses to maintain organs in a warm, functioning state. With OCS, the warm state mimics the environment of the human body during transport from organ donor to recipient. Nutrient rich, oxygenated blood is continuously pumped through the heart in order to maintain the organ in a living, beating state. Preserving an organ with this method reduces cold ischemic time and allows for evaluation of organ function during transport.
About ISHLT
The International Society for Heart and Lung Transplantation (ISHLT) is a not-for-profit organization dedicated to the advancement of the science and treatment of end-stage heart and lung diseases. Created in 1981, the Society now includes more than 3,000 members from 45-plus countries, representing a variety of disciplines involved in the management and treatment of end-stage heart and lung disease.
ISHLT maintains two vital databases. The International Heart and Lung Transplant Registry is a one-of-a-kind registry that has been collecting data since 1983 from 223 hospitals from 18 countries. The ISHLT Mechanical Circulatory Device (MCSD) database has been collecting data since 2002 with the aim of identifying patient populations who may benefit from MCSD implantation; generating predictive models for outcomes; and assessing the mechanical and biological reliability of current and future devices. In Fall 2006, ISHLT released the first international guidelines for heart failure patient management. For more information, visit www.ishlt.org.