The process of organ transplantation from the donor hero to the recipient may seem like a complex but straightforward process — but behind it is an intricate system of collaboration between surgical teams, organ procurement organizations (OPOs), and perfusion providers. The vast amount of moving parts and personnel requires planning and collaboration to achieve the goal of a successful transplantation. Communicating with donor families and recipients, procuring organs, preserving them, synchronizing the surgical team, arranging transport, and ultimately implanting the perfused organs is a complex endeavor, but it can be executed well when every party is aligned within a well coordinated endeavor that fosters success.

What Is Normothermic Perfusion?

Normothermic Regional Perfusion (NRP) is changing the landscape of organ transplantation by extending the donor hero window and assessing the viability of organs from DCD procedures. “Excellent early outcomes with liver and kidney transplantation” are driving the increased utilization of NRP for DCD donors, according to Current Opinion in Organ Transplantation. Moreover, the United Network for Sharing Organs (UNOS) says that perfusion of DCD hearts can potentially lead to 300 more adult heart transplants annually.

The process of NRP provides the ability to replicate implantability in order to assess organ function and short to long term success. NRP can be utilized in collaboration with either ex-vivo and/or cold storage methods of preservation, resulting in more valuable time for surgical preparation, recipient travel, and organ transport. Cureus says that NRP is more feasible compared to the OCS heart machine and could reduce the need for ex-situ perfusion devices for individual organs, however is dependent upon case by case scenarios.

What Does It Take to Build an Ecosystem for Normothermic Regional Perfusion?

In evaluating a TA-NRP program that conducted 30 organ procurements over the course of the study period, Annals of Cardiothoracic Surgery stated that key program elements included “identification of key stakeholders, early communication, proactive navigation of ethical concerns, staffing and equipment needs, and development of TA-NRP algorithms for pre, intra- and post-donation phases of care.”

Communication between all parties involved is mandatory, and operational challenges must be addressed in order to have a successful surgical outcome. To build an ecosystem for NRP, the following factors have to be considered and aligned:

Logistics

The logistics of a successful procedure includes the coordination of all surgical teams involved.  The initial step after coordinating travel and staffing is an OPO checklist in which the entire team is prepared to go through the operational process.  The perfusion team involved may be working with up to 4 teams from programs throughout the United States.  The preparation through the operational checklist for an NRP Perfusion Specialist may include prime components, cannulas, or any other special requests via surgeon or receiving center’s request.

Workflows

According to JAMA Network Open, organ allocation may increase the volume of normothermic perfusion cases, indicating that OPOs need guidelines and standardization to maximize their ability to give organs. Implementation of guidelines can improve the strategic workflow for teams, allowing them to work together more easily and streamline their efforts toward their collective goal. Having appropriate workflows for teams before, during, and after organ donation increases efficiency and reduces the risk of potential loss. 

Shared Data

Sharing data is absolutely essential to maintaining optimal collaboration among transplant teams, OPOs, and perfusion providers.  As a leader in NRP in the Midwest, Specialty Care maintains the same standards as we do for Open Heart and ECMO cases. Specialty Care maintains the diligent data gathering throughout NRP via documentation and CMS guidelines.    

Staffing Models

Reliable staffing plays an instrumental role in ensuring that processes are executed according to plan. When team members or providers are unavailable, the logistical challenges increase, data can fall into gaps, and the chance of success begins to diminish. When the resource pool goes dry, operations fail faster and more frequently. Adequate staffing of trained professionals, strategic redundancies, and contingency planning can go a long way in improving outcomes.  Specialty Care provides an NRP team available 24/7 – 365 in order to provide an essential program that fosters donor heroes the ability to extend their gift.

Get NRP Support for Organ Transplants

At SpecialtyCare, we’re experts in training, systems, and data that set up surgical teams for success. We provide education and credentialing for perfusionists to meet the growing need for perfusion services, and we currently employ 430 perfusionists nationwide, supporting more than 750,000 cardiac surgeries each year. 

“SpecialtyCare’s national reach in perfusion, NRP, and clinical logistics provides the foundation for a truly paradigm-shifting organ recovery model,” says Dr. Brian Lima, Associate Professor of Cardiac Surgery at Vanderbilt University Medical Center. “Their scale and operational depth uniquely position them to deliver a more reliable, coordinated, and ultimately life-saving approach to heart and lung procurement nationwide.”

We can assist you in developing best practices and workflows for collaboration that drives positive outcomes for organ transplantation. Our team members integrate with yours to promote optimal communication, data sharing, and logistical solutions. If your hospital needs reliable perfusion support for organ transplants, get in touch with us today!