TY - JOUR
T1 - The use of third-party packed red blood cells during ex situ normothermic machine perfusion of organs for transplantation
T2 - Underappreciated complexities?
AU - Callaghan, Chris J
AU - Phillips, Benedict L
AU - Foukaneli, Theodora
AU - Robinson, Susan
AU - Watson, Christopher J E
N1 - Funding Information:
We would like to acknowledge and thank Pankaj Chandak, Tim Maggs, Charlene Furtado, and other colleagues within the Guy?s and St Thomas? NHS Foundation Trust transplant and transfusion teams for their advice and support with the initiation and development of the Guy?s Hospital kidney ex situ NMP program. The University of Cambridge has received salary support in respect of CJEW from the NHS in the East of England through the Clinical Academic Reserve. The views expressed are those of the authors and not necessarily those of the NHS, NHSBT, or Department of Health.
Publisher Copyright:
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Ex situ normothermic machine perfusion (NMP) is being used increasingly in the assessment of higher risk deceased donor organs and to facilitate prolonged organ storage. Third-party packed red blood cells (pRBCs) are often used as an oxygen carrier in the perfusate of ex situ NMP. Despite the increasing interest in NMP, comparatively little attention has been paid to the appropriate selection of pRBCs. This includes the choice of ABO blood group and Rhesus D status, the need for special requirements for selected recipients, and the necessity for traceability of blood components. Flushing organs with cold preservation solution after NMP removes the overwhelming majority of third-party allogeneic pRBCs, but residual pRBCs within the organ may have biologically relevant effects following implantation as they enter the recipient's circulation. This review considers these issues, and suggests that national transplant and blood transfusion agencies work together to develop a co-ordinated approach within each country. This is especially important given the possibility of organ re-allocation between centers after ex situ NMP, and the ongoing development of organ perfusion hubs.
AB - Ex situ normothermic machine perfusion (NMP) is being used increasingly in the assessment of higher risk deceased donor organs and to facilitate prolonged organ storage. Third-party packed red blood cells (pRBCs) are often used as an oxygen carrier in the perfusate of ex situ NMP. Despite the increasing interest in NMP, comparatively little attention has been paid to the appropriate selection of pRBCs. This includes the choice of ABO blood group and Rhesus D status, the need for special requirements for selected recipients, and the necessity for traceability of blood components. Flushing organs with cold preservation solution after NMP removes the overwhelming majority of third-party allogeneic pRBCs, but residual pRBCs within the organ may have biologically relevant effects following implantation as they enter the recipient's circulation. This review considers these issues, and suggests that national transplant and blood transfusion agencies work together to develop a co-ordinated approach within each country. This is especially important given the possibility of organ re-allocation between centers after ex situ NMP, and the ongoing development of organ perfusion hubs.
UR - http://www.scopus.com/inward/record.url?scp=85094948454&partnerID=8YFLogxK
U2 - 10.1111/ajt.16355
DO - 10.1111/ajt.16355
M3 - Article
C2 - 33048419
SN - 1600-6135
VL - 21
SP - 1376
EP - 1381
JO - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
IS - 4
ER -