In the United States, more than 33,000 donor organs are not used each year because they are found to be unsuitable for transplant, contributing to the deaths of more than 6,000 people annually who were on an organ waiting list but never received a transplant.
But there are many new approaches that have been proven to increase the number of available organs for transplantation, including emerging techniques of rehabilitating organs that would once have been discarded as unusable.
Those were some of the findings of a comprehensive literature review authored by VUMC researchers that was recently published in the journal The Lancet.
The group of Vanderbilt researchers was invited by The Lancet to contribute the article, “Scientific advances in the assessment, modification, and generation of transplantable organs for patients with end-stage organ diseases.”
“We were focused on defining the magnitude of donor organ scarcity and summarizing some of the new science that will help,” said co-author Ciara Shaver, MD, PhD, assistant professor of Medicine and associate director of the Vanderbilt Center for Transplant Science. “If you can describe where the barriers are and where the opportunities are, then hopefully we can catalyze more people to pay attention to the need for additional organs. And that can foster and encourage investment in the science of transplantation.”
The review found that donor organs discarded each year in the U.S. included 80% of lungs, 70% of hearts, 40% of livers and 27% of kidneys. This problem is global, and new innovations are emerging from transplant innovators across the world, many of whom collaborate with Shaver’s lab.
Shaver said she looks forward to a day when there are enough available donor organs for everyone, a goal which she believes will be achieved in her lifetime.
There are many areas the paper identified for improvement. Approaches for assessing the quality of donated organs can be refined so that more organs would meet criteria for transplant, using refined metrics and tissue biopsy analyses.
New organ recovery platforms can be deployed, such as optimization of storage temperatures of recovered organs or utilization of machine perfusion to preserve organs over longer distances, reducing ischemia in organs considered donation after cardiac death, or DCD. Perfusion can also be deployed to modify donated organs to be more suitable for transplant.
Lastly, the paper considers the new frontier of creating new organs suitable for transplantation, including modifying animal organs for transplant into humans.
Other Vanderbilt faculty authors of the paper are Peter Reese, MD, PhD, professor of Surgery, Biostatistics and Medicine and director of the Vanderbilt Center for Transplant Science; and Matthew Bacchetta, MD, MBA, the H. William Scott Jr. Professor of Surgery and professor of Cardiac Surgery and Thoracic Surgery.
Shaver said Vanderbilt transplant scientists were invited to lead the paper because of their expertise in helping introduce new techniques to grow the organ donor pool, including new storage and procurement tools and perfusion techniques to protect donated organs before they are transplanted. This manuscript initiates a comprehensive three-part Clinical Series on transplantation by The Lancet, with Reese leading the initiative for the prestigious journal. VUMC authors are involved in all three parts of the series.
“Being invited to submit this paper recognizes the leadership of the Vanderbilt Transplant Center and its investment in science and transplant,” Shaver said. “We couldn’t do this without the support of our clinical teams and the support of our institution overall to invest in the science and discovery and allow us to bring those discoveries to our patients.”
Shaver will be leading a free webinar related to the research July 7 at noon CDT, presented by The Transplantation Society in collaboration with The Lancet, the American Society of Transplantation and the European Society of Organ Transplantation. To learn more details and register, visit https://tts.org/index.php?option=com_content&view=article&id=1635&Itemid=119.
