Transplant-Surgery System Maintains Viable Organs

A new transplant-surgery system may make it possible to transplant organs that would otherwise not be transplantable.

The system is designed to maintain and improve organ health, increase the amount of time that an organ can remain outside the body, give surgeons the opportunity to assess and potentially improve the function of the organ, and increase the availability of viable organs for transplant. The TransMedics organ care system, developed by Transmedics (Andover, MA, USA), includes a specialized machine that, for example, keeps a heart beating and warm until it is ready to be used. This eliminates the need for packing the heart in ice, as the current method requires. The system is currently limited to investigational use in the United States.

The system incorporates technologies that simulate the conditions of the human body and allow the organ to function as it normally does. At the core of the system is the perfusion module, a transparent, sterile chamber designed to protect the organ and maintain the appropriate warm temperature, humidity, and solutions required for organ maintenance. Donor blood is used, and the system provides for blood oxygenation and flow from an internal gas supply and pulsatile pumping system. A proprietary solution is infused to replenish depleted nutrients and other necessary substrates in the blood. The system also protects the organ from contamination. Finally, a compact wireless monitor provides important information to allow assessment of the organ by a physician. In the case of the heart, parameters such as aortic pressure, coronary flow, blood temperature, and heart rate are monitored.

The system enables full functional, biochemical, and metabolic assessment of the organ, and may enable the utilization of organs that are currently wasted due to the limitation of the existing preservation method, by allowing the transplant surgeon the time to potentially resuscitate the organ ex vivo to build up its energy stores, optimize its function, and perform full viability assessment prior to transplantation.



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