Rapid in vivo multiple organ cooling prior to harvesting

The need for extrarenal as well as renal grafts for transplantation surpasses the number of available donated organs. It is important, therefore, to utilize maximally available donors so that organs from cadaveric sources are not wasted. This experimental study tested a new method for multiple organ harvesting that used a technique for rapid in vivo organ cooling by nonpulsatile pump perfusion prior to harvesting. Kidneys, livers, hearts, and pancreases were obtained from ten mongrel dog donors. Kidneys and livers were transplanted into unrelated canine recipients as heterotopic and orthotopic allografts, respectively. Satisfactory function (serum creatinine 1.4 mg/dl) was obtained in all 20 of the renal transplants in the immediate postoperative period. Hepatic allografts also demonstrated satisfactory function with nine of ten liver transplant recipients surviving past the first 24-hour critical period. In addition, biopsies obtained from the simultaneously harvested hearts and pancreases showed normal histology. In summary, this technique provides more consistent cooling of donor organs prior to procurement and therefore effectively reduces warm ischemia and associated compromise of viability during multiple organ harvesting procedures. Clinical application of these techniques would undoubtedly lead to improved quality and an increased supply of usable organs from cadaveric donors.