Organ banks and the potential of deep-freezing

We still face major challenges when it comes to the availability of donor organs. Organ banks could be a promising solution to shorten waiting times and save more lives - but only if we manage to preserve donor organs for longer.

In an interview with MEDICA-tradefair.com, Prof. Gerald Brandacher explains the obstacles to still be overcome and the current state of research.

Prof. Brandacher, you recently returned to the Medical University of Innsbruck from Johns Hopkins University in the USA. Could you tell us something about your research projects and, in particular, about the long-term preservation of organs?

Prof. Gerald Brandacher: One of our main research goals is to develop a highly specialized cooling technique that makes it possible to preserve organs for longer periods of time. It has always been possible to freeze or refrigerate organs, but research has encountered the problem of ice formation during thawing.

This ice formation led to cell damage and tissue damage, making the storage of organs at ultra-low temperatures almost impossible. However, significant progress has been made in recent years to prevent or at least minimize this ice formation.

Nature has served as inspiration for this development. Various animal species, such as fish, frogs and other survivors in extremely cold environments, have the ability to generate protective proteins. These proteins prevent the formation of ice and protect the organs from damage. Researchers have now been able to chemically synthesize these proteins and use them therapeutically.

Can you tell us more about the cold preservation technology and how it is used?

Brandacher: The cold preservation technology we are researching involves supercooling and vitrification, where organs are preserved without the formation of ice. This allows organs to be stored for days, weeks or even months. These methods are already being used in reproductive medicine to preserve embryos and egg cells.

Temperature plays a decisive role here. By lowering the temperature to ultra-low temperatures of around -150 degrees Celsius, the tissue enters a so-called glass stage in which it can be stored indefinitely.

However, we are currently focusing on an approach that is probably more practical, with a temperature range between -5 and -10 degrees. Here, organs can be transported completely without ice formation through the use of cryoprotective peptoids. We believe that with this technology it will be possible to gain viability of between three and ten days. This would allow organs to be exchanged worldwide.

An important aspect is the "thawing" procedure. How are the organs performed and tested in a warm state?

Brandacher: The organs are "thawed" using machine perfusion. This specialized procedure makes it possible to connect the organs to a device that imitates blood flow. At body temperature, organ function is maintained, monitored and, if necessary, optimized outside the body. In Innsbruck, we are leading the way in introducing this technique into routine clinical practice and have already achieved considerable success, particularly in the pre-treatment of livers. Our next challenge is to apply this method to kidneys.

Why is the long-term preservation of organs so important and how could it have a positive impact on transplant medicine?

Brandacher: Longer-term preservation of organs would be a major breakthrough for transplantation medicine. It would enable surgeons to choose the most suitable organ for their patients from a larger selection of organs. Currently, many organs, such as hearts, kidneys and livers, can only be stored for a short time. With this new technology, we could significantly improve the availability of organs and thus help more people.

Overall, organ banks offer promising prospects for the future of organ transplantation. Advances in freezing technology and the possibility of using protective peptoids therapeutically open up new possibilities for the storage and availability of donor organs.

If these challenges can be overcome, we are on the brink of a revolution in transplant medicine. With organ banks and freezing technology, we could improve the availability of donor organs and give many people around the world a new lease of life.