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 evaluated lungs post EVLP

Introduction to Organ preservation

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 deceased 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 reduced or arrested if the organ is rapidly cooled and stored in a uniquely protective preservation solution like PERFADEX® Plus.

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:

  • If the donor is a DCD, warm ischemia begins when blood pressure becomes insufficient for organ perfusion and continues until hypothermic flush
  • If the donor is a DBD organ damage occurs as an effect of cytokine storm and other determinental effects intiated at the time of brainstem death and continues until hypothermic flush
  • Cold ischemic phase (when preserved in hypothermic state)

Much of the injury to the transplanted organs occurs not during ischemia, but during reperfusion.


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, other sub-optimal/marginal lungs and lungs donated after cardiac arrest (DCD) currently rejected for use.

The function of these lungs can now be assessed with normothermic ex vivo lung perfusion (EVLP) technique, thus 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  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
  • Opportunity to reassess prior to transplant