UNC Charlotte faculty initiative increases viability of organ transplants
Each year, more than 120,000 people across the nation wait to receive a life-saving organ transplant. Unfortunately for those on the waiting list, only about 3,500 transplants take place because of a lack of donor organs.
Beyond the medical challenges of matching a patient with a donor organ that won’t be rejected after a transplant, there are logistical issues for medical staff to deal with as well. A kidney only lasts up to 36 hours once it’s removed from the donor, while a heart lasts three to five hours and a liver only four to 16 hours. Many organs are rendered unviable before they reach a matching recipient.
A group of faculty members across multiple disciplines at the University of North Carolina at Charlotte are working to extend the life of donor organs and find better ways to match recipients. The project, called the Charlotte Banks Initiative, was formed about 18 months ago and received a grant in April from the National Institute of Health to host an Organ Banking Summit this August in conjunction with the Organ Preservation Alliance and Harvard Medical School.
Gloria Elliott, associate chair of research of biomechanical engineering and engineering science at UNC Charlotte, serves as director of the Charlotte Banks Initiative. She has worked over the past couple of years with the Organ Preservation Alliance, a nonprofit group trying to jump-start tissue and organ preservation research.
“When I was working with the group on strategies, I came to realize that we have a lot of talent at UNC Charlotte to tackle some of the technical hurdles we had identified,” she said. “I pulled together faculty just to brainstorm to find out what they thought. I got a lot of enthusiasm, and that’s when Charlotte Banks was born.”
The initiative covers a broad range of disciplines, including mechanical engineering, physics, biology, chemistry, economics, public health policy and systems engineering, Elliott said. The group worked with LifeShare of the Carolinas, a Charlotte-based organ procurement service, to hold a symposium on Valentine’s Day – also National Donor’s Day — to discuss some of the challenges facing organ transplantation.
“Charlotte Banks is unique in many ways, and in the ways it will help procurement organizations like us as well as the transplant community,” said Sarah Seiler, chief operating officer for LifeShare. “They are doing a lot of research to get to the point where we will have plenty of organs. They are working on different technologies to do that.”
Holistic Approach
Elliott said the various UNC Charlotte faculty members are applying for research grants in their own specialty fields to take a multi-pronged approach to organ preservation.
“We get together and write proposals and try to come up with the new technologies in this area,” she said. “There’s a lot of enthusiasm and a lot of support at the university level. They’ve really been behind us.”
One area the researchers are exploring is the process of placing organs in cold storage to extend the time between harvesting and transplant.
Elliott’s own lab is working on deep cold storage technology, known as cryogenics, where the organs are preserved in liquid nitrogen. Elliott’s team is working on the challenge of developing low-toxicity protectants and delivering them into the tissue that counteract freezing stresses.
Some of the UNC Charlotte researchers are working to restore full functions in livers that are marginally healthy, using the cold storage process to rejuvenate the organs.
The initiative goes beyond the lab work. For example, Gabriel Zenarosa, a UNC Charlotte assistant professor of systems engineering, is using data modeling to develop ways that would allow more people on transplant lists to receive organs. He said some of the harvested organs can’t be transplanted because they might have a medical issue that would make them unviable.
Zenarosa is interested in learning the decision-making process behind whether or not a donor heart is determined to be viable for a given recipient.
Zenarosa said each patient on a transplant list is assigned to a geographic area and the organ must be transplanted within a certain radius because of the short viability time. Zenarosa said he is working on models to show that if preservation times could be extended and the geographic range could be expanded, more patients would be able to receive donated organs.
“The current transplant protocols have people who are local getting higher priority, even though a more compatible patient might be in the next region or next state,” he said. “One of the things officials are doing now is expanding the zones so that the sickest patients go first, just to get rid of the inequities in the system.”
Because UNC Charlotte is one of the leading universities in the nation specializing in Big Data, Zenarosa has resources to accumulate data into different sets that would allow doctors to analyze patients using different criteria.
“It helps the patient get more patient-specific care,” he said. “Hopefully, it gives them the best chance to survive. It’s better to have more data.”
Seiler said that studying the social science aspect of organ transplants can be as important as the biological science.
“Being tied with the UNC system, Charlotte Banks can assist with developing some of the social sciences side – what makes people consent or not consent to transplants?” she said. “It helps dive into the ‘whys’ of transplants. So I think it’s going to be a good partnership to help grow organ transplants and donations.”
Another avenue the initiative is exploring is artificially made tissue, such as through 3-D printing.
“Right now, we evaluating new technologies with a blood vessel model, as preserving blood supply is an essential component of preserving solid organs,” Elliott said. “We’re testing new short- and long-term storage compositions and rewarming technologies by demonstrating that we can preserve the endothelial cells in the blood vessels as well as the smooth muscle tissue around the vasculature. What we learn in these systems will be equally applicable to engineered tissue.”
Long-term goal
Currently, nearly 3,000 people in North Carolina are on an organ-transplant list, according to Elliott. Unfortunately, many will not receive the organ they need in time.
Seiler said that the longer the viability of an organ can be maintained, the more options the transplant team has. For example, going through the transplant list can be a long and complicated process that takes up valuable time as the transplant team works to find the best match.
“It would allow much more time to find the perfect match,” she said. “People might think it’s like going through a phone book-type list, but it’s not because you are looking at medical histories. It could take quite a while just to get to the fifth or sixth person on the list.”
In addition, Seiler said, there are companies who are working to optimize organs to make them as viable as possible. For example, a company in Colorado has developed a kidney pump that takes a marginal kidney and works to make it better. Similar techniques are being done with lungs and hearts as well.
“We might be able to recover more organs that we would consider to be not-quite perfect,” she said. “That would be incredibly helpful.”
While many companies are looking for ways to preserve and extend the life of organs, Seiler said Charlotte Banks has a distinct approach to the work.
“What makes Charlotte Banks unique is that it’s part of a large university system,” she said. “I think that will potentially help them grow and us to develop an even better partnership to serve the community.”