Evaluation of Current Organ Packaging and Storage Patterns Between Brazilian Renal Transplant Teams

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Abstract

Introduction

In Brazil, technique of cold static storage of organs for transplantation is determined by a Brazilian Health Regulatory Agency’s guideline, based on the American and Spanish recommendations. Our hypothesis is this standardization is incomplete and unclear what can generate lack of uniformity among the teams’ practices. The present study aims to evaluate the compliance of the transplantation teams with the static cold storage standards and whether there is uniformity between the teams in the unwritten aspects.

Methods

An electronic form was e-mailed to all kidney transplantation teams in the country. The analysed variables were: transport container type; contents of the organ’s coating package (written in the standard) and volume of the container; ice format; ice filling in container; organ preservation solution; way of coated organ storage in the container; presence of temperature control in the container (not written in the standards). All variables were categorical and the chi-square test was used to evaluate whether the distribution of the observed responses met the expected pattern. The level of significance was p <0.05.

Results

Twenty-seven renal transplant teams answered the questionnaire, which represents 2,625 kidney transplants per year (2015), 47.31% of the country's total. It was in accordance to the expected distribution among the teams (p> 0.05): transport container type (styrofoam-0%, thermal box −100%, p> 0.05). It was not in conformity to the expected distribution (P <0.05): volume of the container (9L-18.5%, 34L-70.4%, 50L-11.1%, p <0.001), ice filling in the container (yes-70.3%, no-29.7%, p=0.034), organ preservation solution (Euro Collins™37.5%, IGL™-22.2%, SPS™-14.8%, Custodiol™-25.9%, p = 0.037), ice format (crushed-25.9%, cubes-74.1%, p=0.012), contents of the organ’s coating package (organ only-14.8%, organ preservation solution-74.1%, saline-11.1%, p <0.01), way of coated organ storage in the container (direct in contact with the ice- 66.7%, packed in plastic pot-22.2%, packed in metal box-11.1%, p <0.01), presence of temperature control in the container (yes-22.2%, no-77.8%, p = 0.004).

Conclusions

Most teams are not completely in accordance with the Brazilian packaging recommendations. On the other hand, the aspects not written in standards, presented an uneven distribution. Future studies may assess whether these technical differences have an impact on the outcome of the transplants performed.

Conclusions

Dr. Valter Duro Garcia - Conselheiro Consultivo da Associação Brasileira de Transplante de Órgãos (ABTO). Central Estadual de Transplantes de Rondônia (GCETRO). Secretaria Municipal de Saúde de Porto Velho (SEMUSA-PVH). Programa Institucional de Bolsas de Iniciação Científica (PIBIC)/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ).

References:

1. Agência Nacional de Vigilância Sanitária (Brasil). Resolução n. 66, de 21 de dezembro de 2009. Dispõe sobre o transporte no território nacional de órgãos humanos em hipotermia para fins de transplantes. Diário Oficial da República Federativa do Brasil. 23 dez 2009; Seção 4.

References:

2. Garcia VD. Veículo Oficial da Associação Brasileira de Transplante de Órgãos. Registro Brasileiro de Transplante. 2015; 4.

References:

3. Net M, Trias E, Navarro A, Ruiza A, Diaz P, Fontenla JR, et al. Cold chain monitoring during cold transportation of human corneas for transplantation. Transplantation Proceedings, 2003 Aug; 35(5): 2036–8.

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