Organ transport temperature box: multicenter study on transport temperature of organs

Horch, D; Mehlitz, Thomas; Laurich, O; Abel, Assavedo Codjo Rodrigue; Reuter, Sven; Pratschke, H; Wesslau, C

doi:10.1016/s0041-1345(02)03253-0

Cited by 18 publications

(21 citation statements)

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“…Temperatures between 4-8 ℃ are widely accepted as best range for optimal high energy phosphate preservation, low risk of cold injury and good post-transplant function (8). One study involving 186 transplanted organs showed that organ transportation and cold storage using usual packing procedures following the Eurotransplant guidelines led to organ temperatures reaching even below 0 ℃, with an average below 2 ℃ in all packing procedures (9). It is known that temperatures below 2 ℃ significantly increase the risk of cold injury and frostbite, which can further lead to primary graft failure (10,11).…”

Section: Discussionmentioning

confidence: 99%

“…Since we do not routinely measure organ temperature during organ transportation with the three bag technique, so we do not have own data to compare but compared our results with data published by Horch et al (9) previously. These authors showed an average organ temperature below +2 ℃ in 186 organ procurements raising concerns regarding cold cell injury.…”

Section: Discussionmentioning

confidence: 99%

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First clinical experience with the novel cold storage SherpaPakTM system for donor heart transportation

et al. 2020

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Background: The current gold standard for donor heart preservation is a three-bag-technique and storage in a cooler filled with slush ice. This technique can cause freezing injury with protein denaturation. We report our early experience with a single-use disposable device (SherpaPak™, Paragonix Technologies, MA, USA) specifically designed for sterile permanent temperature-controlled transportation of donor hearts. Methods: In this case control study with 2:1 matching we identified 21 patients after heart transplantation depending on type of organ transport (standard three-bag-technique vs. SherpaPak™). The outcome after donor heart storage in the SherpaPak™ was compared with donor heart transportation with the standard technique. Results: Since July 2018 seven patients (5 males; mean age 50.3±13.2years) underwent heart transplantation with the SherpaPak™ system. Cold ischemic time was longer in the SherpaPak™ group (207.7±23.3 vs. 181.6±21.9, P=0.027). SherpaPak™ kept the organ temperature at 5.1±0.8 ℃, with an average outside temperature of 21.4±3.6 ℃.Among all 21 transplanted patients four developed fatal early graft failure (28.6% vs. 21.4%, P=0.432). Over the first hours we noticed no difference in hemodynamic parameters, CK-MB levels or vasoactive-inotropic score. During first follow-up we noticed slightly better right heart function in the SherpaPak™ group (TAPSE 17.83±2.71 vs. 14.52±2.61 mm, P=0.020). We identified no positive blood cultures in the SherpaPak™ group within the first 30 days after heart transplantation. Conclusions:The SherpaPak™ provides a constant temperature during transportation with permanent monitoring, never dropping below 4 ℃.Organs transported with this novel device showed a normal perioperative function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

First clinical experience with the novel cold storage SherpaPakTM system for donor heart transportation

et al. 2020

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“…Current CS technique for donor heart preservation limits the total ischemic time to 4 to 6 hours, and longer periods of ischemia are known to adversely affect survival. 1 In addition, the organ temperatures during transportation can decrease to less than 0 C in long transportation, 2 resulting in frost injury and uneven cooling. SherpaPak-CTS is designed to maintain donor heart temperature uniformly within the range of 4 C to 8 C. Preclinical study with pig hearts showed that the device was able to maintain temperature within this range for longer than 12 hours.…”

Section: Discussionmentioning

confidence: 99%

First clinical use of a novel hypothermic storage system for a long-distance donor heart procurement

Naito

Funamoto

Pierson

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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“…However, our own experiences from surface temperature measurements during multiorgan donation indicate a decline of liver surface temperature between approximately 8 to 15°C during cold perfusion, with a gradual rewarming between cessation of cold perfusion and liver removal of approximately 10 to 16°C (data not shown). Temperatures below 5°C are usually achieved within the first hour following packaging 33…”

Section: Discussionmentioning

confidence: 99%

Low viscosity histidine-tryptophan-ketoglutarate graft flush improves subsequent extended cold storage in University of Wisconsin solution in an extracorporeal rat liver perfusion and rat liver transplantation model

et al. 2006

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Adequate flushing for liver donation requires large fluid volumes delivered at a high flow. This can be achieved more effectively with crystalloid solutions than with colloid-based solutions. This study examined the combination of initial histidine-tryptophanketoglutarate solution (HTK) graft flush and subsequent storage in University of Wisconsin solution (UW) to that of the single use of each solution. Livers from inbred Wistar rats were procured using aortic perfusion with UW or HTK for initial perfusion and reflushed after 30 minutes using either solution. In a third group, after perfusion with HTK, organs were reflushed with UW. A 60-minute in-vitro recirculating perfusion was performed after 24 hours of cold storage in the subsequent solution, as well as allotransplantation after 18 and 24 hours of cold storage. In extracorporeal perfusion, the HTK flush followed by UW storage was superior compared to the single use of either UW or HTK solution, as measured by portal venous pressure, bile flow, liver enzymes released into the effluent perfusate, glycerol leakage, and histological examinations. These data were consistent with the transplantation study. Histological damage and enzyme release after 5-day survival were lowest in the HTK flush and subsequent UW storage groups following 18 hours of cold storage; likewise, the 5-day survival was superior following 24 hours of cold storage. In conclusion, the combined use of HTK solution for initial graft rinse and subsequent storage in UW solution resulted in a cumulative protection. Choosing low-viscosity HTK solution for the initial organ flush may represent a feasible improvement in liver preservation, which also further reduces the required amount of UW solution. Liver Transpl 12: [1841][1842][1843][1844][1845][1846][1847][1848][1849] 2006 The maintenance of organ viability during preservation is an important prerequisite for the outcome after liver transplantation. The organ procurement and initial perfusion technique are key factors for improving organ preservation. Good organ preservation starts with an effective blood washout and a rapid decrease of temperature.Preservation solutions are formulated with specific ingredients to prevent cell swelling, impaired energy metabolism, acidosis, and accumulation of precursors of reactive oxygen intermediates. University of Wisconsin solution (UW) became the standard liver preservation solution more than 15 yr ago and may still be regarded as the preferred solution for long-term graft preservation. The disadvantages of UW have been recognized in the past few years; first, the high potassium content of the solution, together with a storage temperature of 0 to 4°C, results in initial vasoconstriction. 1,2 Second, the antiedematous ingredient hydroxyethyl starch 5% causes an almost 3 times higher viscosity at 4°C compared to histidine-tryptophan-ketoglutarate solution (HTK). The high viscosity of UW has been criticized by several groups, who have reported that it results in initial poor perfusion of potential grafts 3...

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Organ transport temperature box: multicenter study on transport temperature of organs

Cited by 18 publications

References 0 publications

First clinical experience with the novel cold storage SherpaPakTM system for donor heart transportation

First clinical experience with the novel cold storage SherpaPakTM system for donor heart transportation

First clinical use of a novel hypothermic storage system for a long-distance donor heart procurement

Low viscosity histidine-tryptophan-ketoglutarate graft flush improves subsequent extended cold storage in University of Wisconsin solution in an extracorporeal rat liver perfusion and rat liver transplantation model

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