Question: Have you heard about the TransMedic Organ Care system which helps keep transplant organs alive outside of body for longer? How does it work?

Anita Thomas answered on 26 Jun 2014:

Hi Hannah,

I’ve worked on cold static storage (the most common way for organ preservation between donor and recipient) in a variety of preservation solutions for kidneys, hearts, livers and pancreas, and a perfusion (pump) system for kidneys. The TransMedic system is a pump system, which is used for hearts. A Phase II clinical trial (called PROCEED I) recently finished (PROCEED II is underway). As I read it, the function of hearts preserved using the TransMedic system was no worse than hearts that had been preserved normally, despite needing a longer surgery (‘cross-clamp’) time. So – the trial found that the TransMedic system wasn’t bad – but doesn’t suggest that it’s massively better, either. Perhaps time will tell – the trial only studied a hand-full of patients, had no integrated controls and only followed the patients for 30 days after the operation. It’s really too early to tell for sure if this particular pump system is any good. Pump systems tested in the past were not better than cold storage in preservation solution. In fact, many pump systems damaged the organs! and so the use of pumps dropped out for quite a while.

Pump systems work by passing a solution that contains nutrients (often including oxygen) through the organ. The problem occurs (when it occurs) as mechanical damage to the organ, as the pump is not sensitive to the changes that occur in the organ during preservation/storage, and cannot regulate itself.