Organ packaging for transportation to prevent freezing damage in Japan

Abstract

In donating from deceased donors, proper temperature control of procured organs is important. It should be noted that not only temperature rise but also ice-up may damage the organs. In July 2021, the Japanese Society for Transplantation published a standard packing protocol for organ transport using a dual-liquid phase to prevent organ freeze damage. We tested the scientific validity of this protocol using bovine livers. The surface temperature and pathology of bovine livers were examined after 6 hours of storage in a cooler box with ice of which the temperature was -20°C or -80°C. In the -80°C-ice group, the organ surface temperature decreased below -0.7°C, the freezing point of the organ preservation fluid, University of Wisconsin solution (UW solution) regardless of the use of the standard packaging protocol. Eventually, the solution and the organ were frozen. On the other hand, according to the standard packing protocol with -20°C-ice, the temperature of the UW solution did not fall below -0.7°C and no icing was observed either in the solution or the organ. Histologically, the normal structure was maintained. The standard packing protocol of the Japan Transplantation Society prevents the icing of the transplanted organs. In this review, we discuss the importance of organ packaging to prevent freeze damage during transportation.