The use of third‐party packed red blood cells during ex situ normothermic machine perfusion of organs for transplantation: Underappreciated complexities?. Issue 4 (1st November 2020)

• Record Type: Journal Article
• Authors: Callaghan, Chris J.; Phillips, Benedict L.; Foukaneli, Theodora; Robinson, Susan; Watson, Christopher J. E.
• Is Part Of: American journal of transplantation. Volume 21:Issue 4(2021)
• Page Start: 1376
• Page End: 1381
• Publication Date: 2020-11-01
• Subjects: clinical research / practice -- editorial / personal viewpoint -- guidelines -- organ perfusion and preservation -- organ transplantation in general; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16355
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : 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. Abstract : The increasing popularity of ex situ warm machine perfusion techniques that utilize third‐party red blood cells in the organ perfusate raises hematological issues that merit consideration.