Cooling Deceased Donors Fails to Boost Post-Transplant Organ Function
Lowering the body temperature of deceased donors in the intensive care unit before organ retrieval does not significantly improve how soon transplanted kidneys, livers, or lungs begin to function. That is the finding of a systematic review published in the Cochrane Database of Systematic Reviews.
Authored by D.R. Amarnath, S.J. Tingle, T.J. Hoather, E.R. Thompson, and C.H. The objective: determine whether therapeutic donor hypothermia enhances transplant outcomes.
The Evidence on Kidney Transplantation Outcomes
Cooling donors to below normal core temperatures—defined as under 35.5°C—may not reduce the time it takes for transplanted kidneys to start working.
Researchers analyzed data from four studies encompassing 3,015 kidney recipients. They found no substantial functional advantage.
Furthermore, data from three studies involving 2,075 recipients indicated that therapeutic hypothermia makes little to no difference to the one-year survival rate of the transplanted kidney. Evidence from one study of 526 recipients similarly showed no difference in overall recipient survival one year post-transplant.
Evaluating Livers, Lungs, and Donor Safety
The evaluation of non-renal organs yielded similar conclusions. Data from single studies showed that lowering donor body temperature did not reduce the time required for transplanted lungs (99 recipients) or livers (262 recipients) to begin working.
Yet, the analysis delivered some positive reassurance. It confirmed that cooling donors is unlikely to reduce the total pool of organs available for transplantation, drawing on four studies with 4,265 recipients.
Additionally, data from three studies involving 2,015 donors demonstrated that therapeutic hypothermia does not cause adverse physiological safety events, such as cardiac complications, in the donors themselves.
Clinical Challenges and Theoretical Benefits
Solid organ transplantation remains the primary treatment for end-stage organ failure. However, donor shortages and organ injury during brain death continue to present major clinical challenges.
Therapeutic hypothermia—achieved through passive cooling, external ice packs, bladder irrigation, or temperature-controlled ventilation gases—is intended to slow the body’s processes and preserve tissue health prior to retrieval.
One-year survival rates for organs were only reported by three studies. Moreover, none of the analyzed studies tracked recipient quality of life, long-term heart disease at 12 months, or specific functional markers such as insulin dependence for pancreas recipients.
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