Organ Care System: Heart
Analicia Behnke, Biomedical Engineering, University of Rhode Island
BME 281 First Presentation, October 23, 2012 <[email protected]>
Abstract—Roughly 2,000 heart transplants are preformed
every year, while 400 people will die waiting for a new heart and
countless potential donor hearts are never transplanted.
Conventional methods of transplantation allow a heart to be
viable for around four hours before it has to be discarded. With a
new method of transplantation, the organ care system, hearts are
viable three times as long and kept beating, allowing for organs
to be transported longer distances and more people receiving the
organs they desperately need.
I. INTRODUCTION
III. RESULTS
The organ care system heart is commercially available in
Europe, but is still in clinical trials in the United States, which
are set to complete in February 2013. However, the current
results from transplants from both Europe and the US show
that the average thirty day patient survival rate was 98 percent,
compared to 93 percent with ischemic, cooled hearts; and the
percentage of cardiac complications was 33 percent, which is
also lower than traditional transplant methods.
T
HE organ care system is the newest method in organ
transplantation.
Through
this
method
of
transplantation, for the heart, the organ is kept
beating the entire time through transportation. This differs
from the conventional method of transplantation, where the
organ is ischemic; cooled below normal temperature, and kept
on ice during transportation. In the conventional method, a
heart is only viable for around four hours before it is deemed
unusable, severely limiting the distance it can travel, and the
potential recipients it could go to. With the organ care system,
or OCS, blood is kept circulating through the heart, keeping it
warmed, at the normal body temperature. The OCS heart
keeps the heart beating the entire time, allowing the organ to
be viable for 12 hours, triple the times of ischemic hearts.
II. METHODS
In order for the heart to keep beating two catheters are
inserted into the heart, for blood to enter, and leave the heart;
one in the aorta, and the second in the pulmonary artery. All
other arteries and veins in the heart are sutured closed to keep
all the blood flowing through the system. The blood leaves the
heart through the pulmonary artery, and goes to the
oxygenator. From there, the blood is pumped through the
heater and then brought back to the heart through the aorta.
The OCS heart is made of three parts; portable platform with
monitor, which houses all the elements and allows for
monitoring heart rate, and aortic pressure; the perfusion
module, which is a sterile chamber that houses the heart in a
sterile environment; and solution set, which provides nutrients
the heart would normally receive in the body.
IV. DISCUSSION
Use of the organ care system has many great advantages to
its use. By using the OCS many more donor hearts will be
able to be transplanted because of the prolonged time they are
viable outside of the body. Hearts will now be able to travel
longer distances, allowing for more potential recipients. Also,
because the organ is kept beating, this allows surgeons to get a
more comprehensive look at the heart before transplant. They
are able to monitor it the whole, taking blood samples, and
using ultrasound machines, to monitor the heart, and ensuring
it is functioning properly before it transplanted, something
they cannot do with ischemic transplants. Limitations of the
organ care system are that it requires much more monitoring
than the traditional cold storage method. Also, for the heart to
maintain proper blood flow, 1.5 liters of blood, with a
minimal hematocrit of thirty percent is needed from the donor.
It is taken through an aortic cannula in forty seconds, right
before the aorta is clamped. The OCS heart is much more
costly than the traditional cold storage method, restricting the
number of hospitals that will be able to have them, which
should be considered as a limitation. The future of the organ
care system looks very bright, with positive results in Europe.
In addition to increased thirty day survival rate, the future
hopes of the OSC heart are to decrease the patients stay in the
ICU, and decrease adverse effects from transplantation,
including rejection, and heart defects.
REFERENCES
[1]
[2]
[3]
[4]
Yeter, R., et al." The Thoracic and Cardiovascular Surgeon 58.S 01 (2010): n.
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<http://clinicaltrials.gov/ct2/show/record/NCT00855712>.
"Enabling the Functional Assessment of Organs for the First Time outside of the
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