Innovation in organ transportation, beating “heart in a box”

Since a couple of years I am a kidney patient. At this moment I have one working kidney and due to that my interest for organ transplantation grew. It can happen that in the coming years I have to undergo this technique but I was never aware about any details behind this process. Unfortunately there is still a long waiting list of not healthy people in need for organ transplantation. Finding the right organ and the possibility to get the organ in a safe and healthy way is still a very big issue which impacts the liveability of the patients. Organ transportation is a critical element of this process and a fundament for successful transplantation. But what are the developments in the world of organ transportation?

Since 1954 we already work on transplanting organs. The process hasn’t changed that much since then. fundamentally, organs still travel via coolers. The organ is removed from one human, sluiced with salt, putted in ice and sent to the other location where the other patient is waiting. This process got challenged and is about to change, based on research on the quality of organ transportation a technology innovation arose. To increase the compatibility of the organ towards their new body it needs to stay in functioning state and body temperature, also during transportation.

New devices are able to more accurately determine the health of the organ before it will be transplanted. These devices can real time monitor the health of the organ. They use a innovation called “ex vivo warm perfusion” that creates the circumstances in where an organ can stay longer outside a body. This creates a situation where organs can be delivered to way further destinations.
At this moment, regarding viability, kidneys can stay healthy and ready for transplantation with 36 hours frozen in ice. However hearts and lungs can unfortunately only stay out of the body in ice for 4 to 6 hours. These new ex vivo systems increases the amount of hours significantly.

“Beating heart in a box” proposition

This mentioned ex-vivo system brought us a new product, beating heart in a box. During transportation the box pumps warm, oxygenated and enriched blood through the heart which keeps it in working conditions. It’s a small box from maximum 1 m2 and made on wheels to ease transportation. Equipped with oxygen, blood, Batteries, and monitoring systems (humidity and temperature). Transmedics is one of the main suppliers on this new technology. And invented and produced the “heart in a box” as seen below.

heart in a box

The organ believes that it’s still in the body,” says Dr. Waleed Hassanein, president and CEO of TransMedics, the Andover, Mass.-based medical device company that’s developing the system. “The heart is beating. The lung is breathing. The liver is making bile. The kidneys are making urine.”

Because the organs are functioning during transport, doctors can monitor the organs and in some cases make them healthier, Hassanein adds. Antibiotics can be delivered to an organ to prevent or treat an infection. Clinicians can inflate sections of a donor lung that have collapsed.

So as we can see the technology is there and proven. However it is still an expensive process and obtaining all the medical certificates are the major challenges to bring this product to a majority market. Accessibility of the right organs is a big issues for patients who have to wait for a new organ. However this technology enhances the accessibility and can hopefully save life’s in the future!


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