Ex situ organ preservation

This advisory report on ex situ organ preservation replaces advisory report SHC 8711 from 2011, due to growing demand and a change in donor profiles. Nowadays, there are more older donors and more donations after circulatory death (DCD), which results in higher-risk organs and necessitates better preservation.

Ex situ preservation techniques such as machine perfusion reduce damage, improve organ quality and thus lead to more usable organs. Clinical applicability is growing; studies show an increase in transplants and cost-effectiveness.

The Belgian institute for health and disability insurance, reimburses hypothermic machine perfusion (HMP) for DCD and ECD kidneys in Belgium, which is being applied internationally. The SHC therefore advocates:

• Systematic machine perfusion for all DCD and ECD organs in Belgian centres
• Training and multidisciplinary teams with sufficient know-how
• A national reimbursement framework that covers the costs of the equipment, the operating theatre and personnel
• A register for monitoring survival, complications and transplant numbers

The implementation of ex situ organ preservation will help Belgium remain a leader in the world of transplantation, increase the number and quality of organs, reduce waiting time mortality and offer patients safer transplants.