Jan. 8, 2020 – Tampa General Hospital is the first in Florida to adopt and use a sophisticated organ transplant system that is designed to increase the number of donated hearts, livers and lungs that can be used to save the lives of patients.
The first lung transplant in Florida using this system was performed at Tampa General Hospital on October 22, 2019. The new Organ Care System (OCS™) technology allows a donated heart to keep beating for several hours outside a human body as it is transported to the hospital. This process, called normal temperature perfusion, keeps organs functioning almost as if they were still inside human bodies. During this process, hearts beat, livers produce bile and lungs breathe, all inside portable machines.
“We can maintain the organs for longer periods, which means we can retrieve them from a wider geographic area,” said Dr. John Dunning, surgical director for Heart and Lung Transplantation at Tampa General Hospital and a professor of Cardiothoracic Surgery at the USF Health Morsani College of Medicine. “And, the condition of the organs at the time of transplant is better,” compared to traditional methods.
Tampa General Hospital is the only hospital in Florida and among a handful in the United States to be using or formally studying the process for all three of these organs using the Organ Care System technology. TGH is one of the busiest transplant centers in the nation, having performed more than 10,000 transplant operations. The OCS machines are manufactured by TransMedics, Inc., of Massachusetts.
“At TGH, we use technology and innovation to meet the needs of our community,” said Dr. Kiran Dhanireddy, executive director of the TGH Advanced Organ Disease and Transplantation Institute. “OCS allows us to expand the organ pool by having access to a wider geography of donors, which allows us to save more lives through transplantation.”
The normal temperature perfusion process has already been approved by the FDA for use in lung transplant patients. TGH has conducted five liver perfusion transplants as part of a clinical trial.
“We are continually innovating to provide our patients with optimum care, and cutting-edge technology such as the OCS machine allows us to do that,” said Dr. Amy Lu, a transplant surgeon who is the principal investigator on the TGH clinical trial.
At times, organs are transported to Tampa General from other cities. The traditional method is to use medical coolers for these journeys, which can sometimes take hours. The organs do not perform their normal functions while being transported in cold storage, but their health is preserved for several hours.
The OCS uses a different approach—transporting organs at near body temperature.
In OCS machines, blood, oxygen and nutrients constantly flow through the organs, just as they would inside a human body. So instead of merely being preserved, the organs continue functioning inside the machines. The flow of blood through the heart prompts it to continue beating. The liver produces bile – one of its essential activities. A ventilator puffs air into the lungs. A computer tablet-like device allows surgeons to monitor the health of the organs en route to the hospital.
Organs can survive longer in OCS machines than in traditional coolers. All organs must have blood flowing through them in order to continue as living, functioning organs. While a heart can survive in a medical cooler without a blood supply for roughly four hours, muscle cells will start to die as time goes on. But in the OCS, the heart still pumps and receives blood, so cells can survive longer.
The process has been shown to reduce the number and severity of rejection episodes in lung transplants, and organs in some cases actually get healthier after being placed in the OCS machines. For example, a potential donor who is on a ventilator in a hospital might develop fluid in their lungs as a side effect. But this can clear up when the lung is placed in the OCS. This improvement means more organs are likely to become medically suitable for transplantation. “We can actually monitor their function on the machine and see their function improving prior to transplantation,” Dunning said.
The new technology increases organs available for donation. Currently, lungs are transplanted from patients who have become brain dead. But the OCS also allows transplants from patients whose deaths are classified as cardiac death, which has the potential to expand the donor pool by about 25 to 30 percent.
TGH’s overall goal is not only to provide more life-saving transplants to meet the needs of our community by expanding the available donors, but also to continue to deliver the highest quality of care.
Tampa General has now performed more than 10,000 transplant operations, placing it among the top 10 busiest transplant centers in the nation. Numerous studies have shown that patients do better when they undergo surgeries in large surgical centers where the teams perform complex procedures more often.