Friday, Mar. 22, 1968
Storing Organs
No one knows precisely how many Americans die each year who might be saved by kidney transplants; estimates range all the way from 6,000 to 20,000.
No more than 450 patients receive the transplants, and one reason is that do nor and recipient have to be close to gether, usually in the same medical cen ter, because a kidney begins to deteriorate immediately and will not "keep" more than about four hours.
Last week the University of California's Dr. Folkert O. Belzer described a machine that, he hopes, will keep kidneys in good condition for as long as three days. About the size of an upright piano, the device contains two Plexiglas cylinders in either of which a kidney may rest on a wire screen. Plasma, fortified with body chemicals and penicillin, is fed to the kidneys' arteries through plastic tubes.
An electric pump sends the fluid through the kidneys at a natural pulse rate and under normal blood pressures. Once through, the fluid drops from the veins and ureter into a catch basin for recirculation. Along the way, it is reoxygenated and purified, and chilled to reduce still further the likelihood of organ deterioration. When the machine is trundled from the room in which the kidney was removed to the recipient's operating theater, the pump works on a battery without interruption. Dr. Belzer has done four transplants with machine-preserved kidneys, one of which was on the circuit for 17 hours. All appear to have taken. Animal organ grafts have succeeded after 72 hours.
The point, Dr. Belzer emphasizes, is not to see how long a kidney can be kept, but to give the surgeon more time to do his job better. Most transplants are now performed as emergencies, when a donor becomes available for a patient who has been kept waiting for weeks in the hospital. Belzer's machine, which costs $8,000, gives doctors ample time to do thorough testing of blood and tissue types, and to leave the patient at home until they are sure they have the right match. Such a machine should make it possible for surgeons to use thousands of kidneys from accident victims who die outside the transplantation centers. And it probably can be adapted to preserve hearts.
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