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At Tampa General, a new tool changes the way doctors transplant organs

The ice-and-cooler method is giving way to a device that pumps blood, oxygen and nutrients into donor organs during transport.

In most cases, the job of transporting donor organs is a dramatic event.

The heart or lung is placed in a cooler on ice and loaded into an ambulance or helicopter. Then the clock starts ticking — organs are viable for only a couple of hours outside of a body.

But a new system at Tampa General Hospital is helping to keep donor organs healthier for longer, likely increasing the number of transplants there this year.

The hospital is the first in the state to use the “Organ Care System,” which employs a special device to keep donor organs functioning as if they were still in a body. A donor heart will keep pumping blood. A lung will continue to breathe. Livers will produce bile, all while on the way to a patient in need.

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Tampa General first used the system on Oct. 22.

Dr. Kiran K. Dhanireddy [Tampa General Hospital]

“It keeps the organ at normal body temperature and perfuses it with blood, which basically means the organ is functioning normally for several hours during transportation,” said Dr. Kiran Dhanireddy, executive director of the hospital’s Advanced Organ Disease and Transplantation Institute.

“The standard way would be to cover the organ with preservation solution and put it on ice in a cooler,” he said. “But there is a certain amount of injury to the organ with the cold temperature and storage solution. Keeping the organ at body temperature is preferable.”

Only a handful of hospitals in the country are using the new system, which is manufactured by the medical device company TransMedics Inc. It relies on mobile “boxes” that are outfitted with wires, tubes and a touchscreen tablet. Blood, oxygen and nutrients are pumped into the organ, so there’s no need to preserve it, Dhanireddy said.

A look inside a new Organ Care Systems "box" being used at Tampa General Hospital to keep donated organs functioning longer until they are ready to be transplanted. The "plumbing" features bring needed blood, oxygen and nutrients to the organs. [Tampa General Hospital]

“The organs are connected to plumbing, essentially,” he said. “You can transport them a much farther distance this way. Typically, livers can be transported for 8 to 12 hours. But on the machine, some have gone for almost up to 24 hours.”

The tablet allows surgeons to monitor the health of the organs while en route to the hospital.

The method has been shown to reduce the chance of rejection in lung transplants. Tampa General conducted five liver perfusion transplants with the device as part of a clinical trial, Dhanireddy said.

Medical professionals also hope this method will cast a wider net for sorely needed donors. The U.S. Department of Health and Human Services estimates that 20 patients die a day due to a nationwide shortage of organs.

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The Organ Care Systems device manufactured by TransMedics, shown with a heart. [TransMedics Inc.]

Tampa General can accept donor organs from hospitals farther away using this new tool, and surgeons can use the machines to rehabilitate organs that, in the past, may not have been healthy enough for donation. For example, a patient who is on a ventilator in a hospital might develop fluid in the lungs as a side effect. But the Organ Care System can clear that up, making the organ suitable for transplantation.

Tampa General, one of the 10 busiest transplant centers in the nation, estimates the new device can help expand the donor pool by up to 30 percent.

The hospital has performed more than 10,000 transplant operations, including 585 in 2019 — the most in its history.

“We have one machine for each organ type,” Dhanireddy said. “It’s helping us save more lives, increase the number of transplants we do, and decrease the number of complications with organ function after transplants.”