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Background The Organ Care System (OCS) is a revolutionary ex vivo organ perfusion technology that can potentially expand the organ retrieval range. The OCS Lung device uses packed red blood cells (pRBC) with a proprietary solution. We report the ability to reduce blood waste during this procedure by using a thermal packaging solution in conjunction with the OCS platform. Methods We retrospectively reviewed all OCS Lung recoveries performed by our recovery team, using pRBCfrom May 2019 to January 2021. Initially, units were stored using passive refrigeration with the Performance cooler at a temperature range of 1–6°C for 4 h. Subsequently, thermal control technology with the ProMed cooler was utilized to maintain the same temperature range for 72 h. Results Twenty‐three recoveries were initiated with 63 pRBC. The Performance cooler was used for 8, while the ProMed cooler for 13. 37.5% of pRBC transported with the Performance cooler was used within the validated time range, while 25.0% were used beyond the validated time range based on clinical judgment. In addition, 37.5% of pRBC transported with the Performance cooler were returned to the institution after canceled recoveries with an estimated loss of $1800; the ProMed cooler had no wastage. Conclusions This study showed that using an advanced thermal packaging solution facilitates proper storage of pRBC and represents an advancement for extended donor lung preservation. The elimination of blood wastage in this initial study portends ongoing benefits for the limited blood supply and reduced cost.

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ii) donor age >55 year-old with normal coronary angiography, (iii) reported circulatory down-time > 20mins, (iv) LVEF <50% where impairment is thought to be reversible, and (v) LV hypertrophy (wall thickness 12-16mm). Final transcoronary lactate level < 5 mmol/L at the end of the ex-vivo perfusion period was required for final organ acceptance. Clinical outcomes of interest include: total cold ischaemic time, index hospitalisation length of stay, and allcause mortality at 90-day. Results: Between July 2017 and December 2019, the OCS Heart Retrieval team was dispatched on 9 occasions, with 8 cases of ex-vivo organ retrievals. Of the 8 cases, 6 were successfully transplanted. With a total of 43 heart transplants were undertaken, availability of OCS Heart effectively allowed 14% increase in successful transplantation (6/43). Donor organ retrieval using TransMedics OCS Heart was associated with significant reduction in the total cold ischaemic time compared to cold storage (192.4mins vs 80.33mins, p=0.0005). Despite the expanded criteria, donor hearts that were successfully preserved were associated with comparable clinical outcomes: index hospitalization length of stay (P=0.97) and excellent post-transplant survival (Figure). Conclusion: Normothermic donor heart preservation, with TransMedics OCS, allows comparatively safe transplantation with expanded criteria BD donor organ compared to conventional cold storage method with conservation donor characteristics.

Background The Organ Care System (OCS) is a revolutionary ex vivo organ perfusion technology that can potentially expand the organ retrieval range. The OCS Lung device uses packed red blood cells (pRBC) with a proprietary solution. We report the ability to reduce blood waste during this procedure by using a thermal packaging solution in conjunction with the OCS platform. Methods We retrospectively reviewed all OCS Lung recoveries performed by our recovery team, using packed red blood cells (pRBC) from May 2019 to January 2021. Initially, units were stored using passive refrigeration with the Performance cooler at a temperature range of 1 to 6 °C for 4 hours. Subsequently, thermal control technology with the ProMed cooler was utilized to maintain the same temperature range for 72 hours. Results Twenty-three recoveries were initiated with 63 pRBC. The Performance cooler was used for eight while the ProMed cooler for thirteen. 37.5% of pRBC transported with the Performance cooler was used within the validated time range, while 25.0% were used beyond the validated time range based on clinical judgment. In addition, 37.5% of pRBC transported with the Performance cooler were returned to the institution after canceled recoveries with an estimated loss of $1,800; the ProMed cooler had no wastage. Conclusions This study showed that using an advanced thermal packaging solution facilitates proper storage of pRBC and represents an advancement for extended donor lung preservation. The elimination of blood wastage in this initial study portends ongoing benefits for the limited blood supply and reduced cost.