Therapeutic donor hypothermia following brain death does not significantly speed up how quickly transplanted organs start working in recipients, according to a systematic review published in the Cochrane Database of Systematic Reviews. The research evaluated whether lowering the body temperature of organ donors in intensive care units improves transplant outcomes.
Amarnath, S.J. Tingle, T.J. Hoather, E.R. Thompson, and C.H. Wilson, with support from Cochrane Kidney and Transplant, the review examined data current to September 2025. The analysis focused on whether cooling donors below normal core temperatures preserves organ health before retrieval.
Clinical Findings on Kidney and Multi-Organ Transplants
The review analyzed four separate studies encompassing 2,096 donors to determine if cooling prior to transplantation provides measurable benefits. Two of the studies concentrated exclusively on kidney transplants, while the other two evaluated multiple solid organs, including kidneys, livers, lungs, hearts, and pancreases.
According to the findings, lowering donor body temperature compared to maintaining normal body temperature:
- May not reduce the time it takes for transplanted kidneys to start working, based on four studies involving 3,015 recipients.
- May make no difference to the survival rate of the transplanted kidney one year post-transplant, according to three studies with 2,075 recipients.
- May make no difference to overall recipient survival one year after kidney transplantation, evaluated across one study of 526 recipients.
- May not reduce the time required for transplanted lungs or livers to begin functioning, based on individual studies of 99 lung recipients and 262 liver recipients.
Data regarding other specific organ-related metrics, such as heart function at 12 months or insulin dependence for pancreas recipients, were absent from the evaluated literature.
Safety and Organ Availability
However, the review found that actively lowering donor core temperatures is unlikely to cause safety problems for the donor, such as heart issues, based on data from three studies involving 2,015 donors.
Furthermore, cooling donors does not reduce the overall pool of organs available for transplantation. According to analysis across four studies covering 4,265 participants, the cooling process did not negatively impact organ retrieval rates.
Limitations of Current Evidence
Researchers noted several methodological limitations in the existing body of literature. Only three of the four reviewed studies reported one-year survival outcomes for the transplanted organs. Additionally, recipient quality of life metrics and assessments for heart disease at 12 months were entirely omitted from all included studies.
Most available research centers heavily on kidney donations and recipients, leaving a smaller evidence base for other solid organs like the heart, lungs, liver, and pancreas.