Advance in Preserving Donor Organs Could Expand Pool of transplantable Bodies

Surgeons around the world are experimenting with using genetically modified animal organs for transplants, suggesting a future where transplants are more accessible. However, the field is undergoing a shift towards perfusion, a technique that involves storing organs outside a body temporarily. This technique is impacting every aspect of the transplant process, from how surgeons operate to the types of patients that can donate organs.

Previously, the ideal organ donor was someone who died while maintaining brain activity and whose heart continued to beat, keeping the organs viable for transplantation. However, this technique only preserved organs for up to 12 hours at a time. There has been significant experimentation with techniques that dynamically preserve organs at warmer temperatures, pumping blood or an oxygenated solution through the blood vessels of the donated organ. This technique allows clinicians to properly assess the organ's function and determine how well it would work in a recipient's body.

This has led surgeons to use organs from older or less healthy donors that they may have rejected in the past, according to Dr. Kris Croome, a professor of surgery at the Mayo Clinic. Bolstered by the data, transplant surgeons are now using organs from donors whose hearts have stopped, but whose organs have been kept viable through perfusion. This technique has doubled the number of livers transplanted in the last two years. Previously, surgeons rarely used hearts from donors whose hearts had stopped due to the sensitivity of the organ to oxygen deprivation. However, in 2023, over 600 such hearts were transplanted thanks to perfusion.

The adoption of this new technology may be hindered by its cost. Perfusion adds over $65,000 to the cost of a transplant, which may be prohibitive for smaller hospitals. However, surgeons argue that the technique could save money in the long run, as patients who receive perfused organs have fewer complications and better long-term outcomes.

Scientists are still experimenting with the limits of perfusion, and some, like Dr. Shaf Keshavjee and Dr. Ashish Shah, believe that the technology could allow surgeons to remove, repair, and return organs rather than replacing them, creating "organs that will outlive the recipient."

This article originally appeared in the New York Times.

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