J Nespral

Plain English
Researchers tested a portable machine perfusion device (VP.S ENCORE) that keeps donated hearts alive by pumping oxygenated fluid through them at cold temperatures for up to 8 hours. Hearts preserved this way maintained normal contractile function and kept inflammation markers low, comparable to standard cold storage but with the potential to extend how long a heart can be transported before transplant. The results suggest this device could help transplant more hearts — including ones from donors who live farther away or are otherwise marginal.

Plain English
A study of over 1,300 brain-dead donors examined whether performing a liver biopsy before organ recovery helps or hurts. Biopsies led to more decisions not to harvest the liver, but in liver-only donors and matched comparison groups, this did not actually reduce the number of transplants performed — it eliminated futile surgeries while preserving transplant rates. The findings support wider use of pre-recovery liver biopsies as a cost-saving, efficiency-improving tool, especially for extended criteria donors.

Plain English
A national survey of all 58 U.S. organ procurement organizations found that 82% perform pre-recovery liver biopsies, most often ordered for older, obese, or alcohol-using donors. Most organizations believe the practice is safe and useful, but fewer than half find it easy to obtain. The biggest gaps in opinion concerned accuracy, and centers that biopsy more frequently held more favorable views — suggesting that greater experience and clearer national guidelines could increase appropriate use.

Plain English
Ventilators can sometimes trigger breaths automatically — without any effort from the patient — in a pattern that mimics spontaneous breathing and can delay or prevent brain death testing. This review of 672 organ donor referrals from a Texas organ procurement organization found that 63 cases had documentation consistent with possible auto-triggering. The authors propose an algorithm to help organ recovery coordinators identify and correct this artifact, preventing delays in donor evaluation.

Plain English
A 12-year-old boy died from a brain-eating amoeba (Naegleria fowleri) infection, which normally disqualifies organ donation because the organism infects and kills brain tissue. The transplant team reasoned that since the infection stays confined to the brain, organs outside the skull would be unaffected — and successfully transplanted the kidneys, pancreas, a lung, and the liver, with no post-transplant infections in any recipient. This case established that Naegleria fowleri brain death does not preclude organ donation.

Plain English
A lung transplant program in San Antonio developed a protocol to better manage potential lung donors — including accepting donors previously considered too marginal — and compared outcomes before and after the protocol was in place. Lung procurement rates more than doubled (from 11.5% to 25.5%), with more transplants performed, and more than half of the transplanted lungs came from donors initially deemed unsuitable. Recipient survival at 30 days and one year was similar in both eras, confirming that more aggressive donor management expanded the pool without harming outcomes.