Products

Clinically Optimized Solutions and Systems for Transplantation

Our clinically proven solutions, systems and accessories can be used in the following stages of the organ transplant process:

  • Prior transplantation – Flushing and preservation of retrieved organs prior to transplantation
  • During Normothermic ex-vivo lung perfusion (EVLP) for assessment and evaluation of lungs with or without Red Blood Cells (RBC)
  • After EVLP – Flushing and storage of assessed and evaluated lungs post EVLP

Introduction to Organ storage

Organ transplantation is one of the most challenging and complex areas of modern medicine. Without effective preservation techniques, it would be virtually impossible to transplant solid organs from the cadaver donor to the recipient because irreversible functional injury often occurs well within the first few hours of donor death.

Fortunately, such irreversible injury can generally be prevented or arrested if the organ is rapidly cooled and stored in a uniquely protective preservation solution like PERFADEX®.

In some organs, a marginal functional injury, which can render the organ unacceptable for transplantation, can be improved sufficiently to permit successful transplantation by first perfusing the organ outside the body (ex-vivo organ perfusion) on a closed loop circuit simulating the in-vivo scenario, utilizing a specially developed protective perfusion solution (STEEN Solution™).

The importance of an ideal preservation solution

Removal, storage and transplantation of a solid organ from a donor alters the homeostasis of the interior millieu of the organ. Organ preservation aims to minimize damage to promote optimal graft survival and function.

Damage to organs occurs in two phases:

  • Warm ischemic phase (from circulatory arrest until (cold) hypothermic flush starts)
  • Cold ischemic phase (when preserved in hypothermic state)

Much of the injury to the transplanted organs occurs not during ischemia, but during reperfusion. An ideal preservation solution prevents the development of edema, facilitates aerobic metabolism and prevents pulmonary vasoconstriction.

Introduction to Normothermic perfusion

Organ shortage and low utilization of available donor organs limit the number of lung transplants for centers worldwide. Researchers and lung transplant centers worldwide have been seeking new ways to increase the availability of acceptable organ donors, including the use of lungs from older donors, lungs donated after cardiac arrest (DCD) and other sub-optimal/marginal lungs currently rejected for use.

The function of these marginal lungs can now be improved by the normothermic ex vivo lung perfusion (EVLP) technique, thus further expanding the pool of acceptable donor lungs.

Two approaches have been developed to increase the availability of donor lungs:

  • Lungs from DCD donors or
  • Ex Vivo Lung Perfusion (EVLP) for reassessment of lung function from DCD and brain death donors

Functionality testing of the lung

The aim of normothermic ex vivo lung perfusion (EVLP) is to reproduce the in vivo environment of the donor lung, using ventilation and perfusion. The function of marginal lungs can be assessed using the EVLP technique, thus further expanding the pool of acceptable donor lungs.

 

 

The benefits of Ex Vivo Lung Perfusion

  • Objective assessment of marginal/extended or DCD donors
  • More time to fully assess function and HLA match
  • More time to choose optimal treatment strategy
  • Ex vivo treatment limits side effects of relatively toxic drugs
  • Opportunity to reassess prior to transplant