Impact of Package and Storage Techniques on Kidney Temperature Enviroment


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Abstract

IntroductionStatic or dynamic cold storage of organs for transplantation are key steps to its success, as they have a significant impact on its short- and long-term results. The ideal temperature range for preservation is between 2 and 6°C. This study aims to compare temperature variation among six organ package techniques (plastic bag and thermal transport container).MethodsSix technical variations were tested: 1- Renal standard storage: set of packages placed in a polystyrene thermal container (average size 34 litters) covered with ice cubes; 2- Renal standard + Plastic vessel: standard storage including plastic vessel wrapping plastic bags before placed in ice; 3- Renal standard + Metal case: standard storage including metal case wrapping plastic bags before placed in ice; 4- Renal standard + Crushed Ice: standard storage using crushed ice instead of cubes; 5- Renal Standard + Bar of ice: standard storage using bar of ice instead of cubes; 6- Liver Standard: standard storage in 50-liter thermal container. Variables were analysed using one-way ANOVA with post-hoc Tukey test: A) temperature mean area under the curve inside the packages (TAUCp); B) mean time to reach the temperature nadir (Tnadir); C) duration of temperature within the ideal range (Tideal); D) temperature mean area under the curve inside the thermal container (TAUCt). The temperatures were measured every 30 minutes for 48 hours.ResultsEach of the technical variations were tested five times. There were no differences between groups regarding TAUCp and Tideal (p = 0.550 and p=0,053, respectively). The median Tideal in all groups was 0.5h (0-47.5h). Group 3 had longer Tnadir than groups 5 and 6 (p = 0.018). The group 5 presented temperature mean area under the curve inside the thermal container (TAUCt) higher than groups 1, 2 and 6 (p = 0.008).ConclusionsCold storage, regardless of tested technique, results in temperatures outside the ideal range most of the time. The use of a metal case may delay the time to reach ideal temperature. Although the use of bars of ice causes higher temperatures within the thermal container, this may represent a greater approximation to the ideal temperature range.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.References1. 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 4.2. Dehoff R. Thermodynamics in Materials Science. Michigan: McGraw-Hill Higher Education, 1993. ISBN: 0070163138, 9780070163133.3. Net M, Trias E, Navarro A, Ruiz 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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