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Warming up cold hearts

doi: 10.1097/01.NURSE.0000279427.07284.5c

The American Nurses Association calls for more school nurses…terminally ill patients who enter hospice live longer…raising bed rails doesn't prevent falls…and more.

Ice-filled plastic beverage coolers may be obsolete for transporting donor hearts and other organs if early safety data for a new system hold up. The Organ Care System (OCS) is a self-contained transport system with physiologic monitors, a blood pump, and an oxygenator that can keep a donated heart warm and perfused for hours. It's under investigation as a strategy for shortening the time the heart is kept on ice before transplant.

The device's pump supports the heart with a warmed, oxygenated, nutrient-laced combination of the donor's blood, mannitol, steroids, and epinephrine. The OCS keeps the heart beating while monitoring critical values such as heart rate, aortic pressure, and lactic acid levels.

In a safety study, 20 hearts were maintained in an OCS for an average time of 3.7 hours. All the hearts were successfully transplanted with no instances of graft failure or patient deaths within 30 days of transplantation, researchers reported at the International Society for Heart and Lung Transplantation 2007 Annual Meeting, in San Francisco, Calif., this spring.

The OCS has been developed for transporting hearts, but manufacturer TransMedics of Andover, Mass., is working on a system for kidney, liver, and lung transportation.

© 2007 Lippincott Williams & Wilkins, Inc.