Donor organ shortages is a recurrent theme in transplantation. Conventionally, marginal donor organs would be discarded. The use of marginal or extended criteria organs is one way to increase the donor pool.
Machine perfusion enable the safer use of selected extended criteria organs after assessment.
Organ Care System (OCS) is one type of organ machine perfusion. The OCS has perfusion systems for heart, lung, and liver.
For the heart, the OCS enable the use of extended criteria organs in mainly 3 possible ways:
1) Perfusing warm oxygenated blood to the donor organ, decreasing ischemic injury;
2) Providing functional assessment of the donor organ, allowing further information for decision;
3) Optimization the donor organ, by having the ability of therapeutic intervention such as infusing medications
Our heart transplant team were the first in Asia to use the OCS machine perfusion to successfully transplant an extended criteria donor heart in April 2020. Since it's introduction, we have been able to successfully transplant 3 marginal donor hearts which would otherwise have been discarded.
