Table of Contents
Normothermic Regional Perfusion (NRP) is becoming a more utilized form of preserving organs for donation, and it has the potential to increase the number of successful transplants — especially heart transplants — in the coming years. An increasing number of studies are showing its effects and capabilities in the realms of heart, kidney, liver, pancreas, and lung transplants.
Increase in Heart Transplants
Perfusion can optimize the viability of a heart in cases of donation after circulatory death (DCD). Warm ischemic injury is a real threat to donated heart viability, and perfusion of DCD hearts can potentially lead to 300 more adult heart transplants every year, according to the United Network for Organ Sharing (UNOS). UNOS also states that 199 hearts were successfully perfused and transplanted in 2022, compared to zero just four years prior in 2018.
NRP increases the opportunity for DCD hearts to be transplanted, and it also lowers the barriers to organ preservation because many ICUs already contain ECMO or ECOS equipment that would allow NRP to take place. NRP also eliminates the need for separate perfusion devices for each organ being preserved.
Cureus reports that DCD donation can increase the number of heart transplants by up to 30% — but only if the hearts remain viable. NRP extends the window for viability and even overcomes previous barriers such as distance. “Previously, DCD heart transplantation was limited by the requirement for the donor and the recipient to be in the same location. However, NRP allows us to overcome this limitation,” says Cureus.
Promising Data for Liver, Kidney, and Pancreas Transplants
Current Opinion in Organ Transplantation cites “excellent early outcomes with liver and kidney transplantation” that are fueling the growth of NRP utilizations for DCD donors. Transplantation Direct states that out of 24 liver transplants, 62 kidney transplants, and 3 pancreas transplants from DCD donors using NRP, just two liver grafts and one kidney graft were unsuccessful after one year. It also notes that liver utilization rates were markedly higher with NRP.
Opportunities in Lung Transplants
While some studies have found no discernable difference in utilization rates between DCD lung transplants and DCD lung transplants with NRP, other studies have supported NRP’s potential to increase positive outcomes in lung transplants. Noting that the American Society of Transplant Surgeons now endorses thoracoabdominal NRP (TA-NRP), Current Opinion in Organ Transplantation states that TA-NRP is “an excellent method for recovering both heart and lungs from donation after circulatory death donors and yields satisfactory recipient outcomes in a cost-effective manner.” Additionally, JTCVS Techniques says that TA-NRP has been successful so far in procurement of DCD lung allografts, quelling concerns about the initial quality of the donated lungs.
How to Meet Your NRP Needs with SpecialtyCare
If you’re interested in the possibility of increasing your transplants and prolonging organ viability, getting support for NRP may be your best next step. As the chosen perfusion services provider for more than 250 hospitals around the country, SpecialtyCare can customize an approach to your NRP needs. When it comes to NRP, we offer a response time in as little as two hours and team availability twenty-four hours a day, seven days a week, 365 days a year. Our perfusion specialists can be an integrated part of your team for thoracic and abdominal organ procurement. For an expert consultation on NRP, contact us today. We would love to speak with you!
