Our Summary

This research paper discusses two methods used to preserve and transport organs for transplants: normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP). These methods can help improve the quality of the organs, allow them to be transported for longer distances, and reduce complications after surgery. Both methods often need red blood cells. The researchers began providing red blood cells for these methods in August 2020.

The study looks back at the first three years of using these techniques, examining how many red blood cell units were used, when they were used, and who received the organs. They found that between 2020 and 2023, there were 233 requests for red blood cells for these methods. In 105 cases, the red blood cells were used, while in 112 cases, the units were returned or discarded.

In total, 131 patients received organs, with the majority of heart transplants using NRP and most liver transplants using NMP. In all, 381 units of red blood cells were used for these 131 transplants, averaging out to about three units per transplant.

This suggests that providing red blood cells for NRP and NMP is a new and effective way for transfusion services to support organ transplants. It only requires a modest amount of red blood cells (about three units per transplant) according to this specific study.

FAQs

  1. What are normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) in organ transplantation?
  2. How many units of red blood cells are typically needed for NRP and NMP methods in organ transplants?
  3. What was the success rate of using red blood cells in NRP and NMP methods between 2020 and 2023 according to the study?

Doctor’s Tip

A doctor might advise a patient undergoing an organ transplant to follow their post-operative care instructions carefully, take all prescribed medications as directed, attend all follow-up appointments, and notify their healthcare provider immediately if they experience any signs of rejection or complications. It is also important for patients to maintain a healthy lifestyle, including a balanced diet, regular exercise, and avoiding tobacco and excessive alcohol consumption, to support the success of the transplant.

Suitable For

The types of patients typically recommended for organ transplant are those with end-stage organ failure who have exhausted all other treatment options and are not responding well to medical management. These patients may have conditions such as chronic kidney disease, liver failure, heart failure, lung disease, or other organ failures that significantly impact their quality of life and overall health.

Patients who are considered for organ transplant undergo a thorough evaluation process to determine their eligibility for surgery. This evaluation includes assessing the patient’s overall health, medical history, current organ function, and their ability to tolerate surgery and post-transplant care. Patients with a good overall health status, a strong support system, and a willingness to comply with post-transplant medications and lifestyle changes are usually considered ideal candidates for organ transplant.

It is important to note that organ transplants are typically recommended for patients who have a high likelihood of benefiting from the procedure and have a good chance of long-term success. Patients with severe medical conditions, advanced age, or significant comorbidities may not be considered suitable candidates for organ transplant due to the risks involved in the surgery and post-operative care.

Overall, organ transplant is a life-saving procedure for patients with end-stage organ failure, and it is recommended for those who meet the criteria for surgery and have a good chance of benefiting from the procedure. Providing red blood cells for techniques such as NRP and NMP can help improve the quality of organs and support successful transplant outcomes for these patients.

Timeline

Before the organ transplant:

  1. Patient is diagnosed with organ failure and referred to a transplant center.
  2. Patient undergoes extensive medical evaluations and tests to determine if they are suitable for a transplant.
  3. Patient is placed on the transplant waiting list and waits for a suitable donor organ to become available.
  4. Once a donor organ becomes available, patient is notified and prepares for surgery.

After the organ transplant:

  1. Patient undergoes the transplant surgery to receive the new organ.
  2. Patient is closely monitored in the intensive care unit (ICU) immediately after surgery.
  3. Patient is moved to a regular hospital room once stable and continues to be monitored for any complications.
  4. Patient begins the recovery process, which includes physical therapy, medications, and follow-up appointments.
  5. Patient is monitored closely for signs of organ rejection and may need to adjust medications accordingly.
  6. Patient gradually resumes normal activities and lifestyle, with regular follow-up appointments to monitor the health of the new organ.

What to Ask Your Doctor

Some questions a patient should ask their doctor about organ transplant include:

  1. What are the benefits of using normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) for organ transplants?
  2. How do NRP and NMP help improve the quality of organs for transplant?
  3. What role do red blood cells play in NRP and NMP, and why are they necessary?
  4. Are there any risks or complications associated with using red blood cells in NRP and NMP?
  5. How many units of red blood cells are typically used for organ transplants using NRP and NMP?
  6. How does the use of red blood cells for NRP and NMP impact the success rate of organ transplants?
  7. Are there any specific guidelines or protocols for the use of red blood cells in NRP and NMP?
  8. How will the use of red blood cells for NRP and NMP be managed and monitored throughout the transplant process?
  9. Are there any alternative methods or strategies for supporting organ transplants that do not involve the use of red blood cells?
  10. How can I ensure that I receive the best possible care and support during the organ transplant process, including the use of red blood cells for NRP and NMP?

Reference

Authors: Allen ES, Stephens LD, Weber N, Brubaker AL, Hudson K, Pretorius V, Schnickel G, Kopko PM. Journal: Transfusion. 2024 Oct;64(10):1899-1908. doi: 10.1111/trf.17994. Epub 2024 Aug 24. PMID: 39180488