Storage and transport of heart and heart-lung donor organs with inflatable cushions and eutectoid cooling.

ABSTRACT

A system that uses a chemical method of cooling has been developed for the storage and transport of heart and heart-lung donor organs. This provides a precisely controlled environmental temperature without the use of ice, with its attendant problems of availability and potential contamination with pathogens. Storage and preservation solutions are transported to the donor hospital within the temperature-controlled polyurethane container, and the organs are returned in the same container, within an inflatable cushion. We have used this method for the distant procurement of over 260 hearts and for the most recent 30 heart-lung organ blocks. The mean ischemic time for hearts is 2.5 hours (1.5 to 4.2 hours) and for heart-lung blocks 2.2 hours (1.2 to 4.1 hours). Most donors give multiple organs such as kidney, liver, and pancreas. One patient received heart and kidney grafts from the same donor, and another received combined heart-lung and liver grafts. In relation to primary donor organ failure, there have been four deaths of patients who have had heart transplantations and no deaths of patients who received heart-lung organ blocks. We believe that the method offers advantages over the more conventional methods of organ storage with regard to convenience, temperature control, and sterility.