NRP coverage you can put in a contract.
Normothermic regional perfusion needs a credentialed perfusionist at an unscheduled hour, at a hospital that may not be your own, running a protocol that has to hold up under review. Gate Medicals contracts with organ procurement organizations and transplant centers to provide exactly that — with the documentation to prove it happened correctly.
The circuit is not the new part.
NRP is extracorporeal circulation. Cannulation, flow and pressure management, temperature control, anticoagulation, circuit integrity, weaning — the same discipline a perfusionist runs on cardiopulmonary bypass and ECMO, and has for decades. The purpose is different: the circuit is preserving organs for transplant rather than supporting a patient through an operation.
- Cannulation and circuit setup
- Flow, pressure and temperature targets
- Anticoagulation management
- Circuit monitoring and troubleshooting
- Oxygenator and pump management
- Unscheduled cases, frequently overnight
- An unfamiliar hospital and recovery team
- Death determination and stand-off documentation
- Cerebral-circulation exclusion
- Federal scrutiny and evolving OPTN policy
That split is the whole argument for how we staff NRP. The technical competency already exists — 25 years of it, in our case. What has to be built around it is the protocol discipline and the documentation, because in this setting those are what a case is judged on afterwards.
The standard is the same whoever is on call.
Coverage is contracted per program — per-case, retainer plus per-case, or full program coverage — and scoped to your geography and expected volume.
Call coverage that answers
NRP cases arrive unscheduled and often overnight. Coverage is contracted with defined response and arrival windows written into the agreement, not left to best efforts.
Credential-verified perfusionists
Every perfusionist deployed is primary-source verified, NRP-competency assessed, and simulation-trained before a first live case. Verification files are yours on request.
One protocol, every case
A single written NRP protocol — cannulation, cerebral-circulation exclusion, flow and temperature targets, run limits, abort criteria — applied identically regardless of which donor hospital the case lands in.
A record that withstands review
Contemporaneous documentation of the death determination and stand-off observed, each step and who performed it, circuit parameters across the run, and the cerebral exclusion. Delivered to you after every case.
Competency is not the constraint. Availability is. NRP cases do not respect a schedule, and a program needs someone qualified who will actually answer at 3am and travel to a hospital that is not their own — repeatedly, not once.
The procedure is also ethically contested — the central objections concern the dead donor rule and the exclusion of cerebral circulation — and it is drawing federal attention because of it. An adverse event here is not only a clinical event. It is an institutional one, for you and for the donor hospital.
- Protocols that differ between donor hospitals
- Competency verified by the party supplying the staff
- Records that cannot reconstruct who did what, and when
- No defined authority to stop a case once begun
- Practice that has drifted from evolving OPTN policy
We never govern what we staff.
Gate Medicals exists because a vendor grading its own performance is not oversight. That principle does not get suspended when the vendor is us.
So we hold a firewall, and we publish it: where Gate Medicals provides NRP coverage, we do not also sell independent oversight of that same program. You get one or the other from us, never both. If you contract us for coverage and later want an independent audit of it, we will help you find someone else to perform it — and we will hand over every record they ask for.
We supply the perfusionists and run the cases to a documented standard. Your oversight of us should be independent.
We govern and audit a program someone else staffs — protocols, competency, documentation, case review, policy tracking.
The rules are being written now — not settled.
NRP sits under federal oversight through HRSA and the OPTN. Following reported safety concerns, the OPTN convened a workgroup at HRSA’s direction to develop NRP policy elements, alongside proposed refinements to existing donation-after-circulatory-death policy. Coverage agreements we write are built to adapt as that lands.
The Health Resources and Services Administration oversees the OPTN and directs its policy development.
NRP requirements are set through OPTN policy, developed under HRSA direction and subject to public comment.
At HRSA's direction, the OPTN convened a workgroup to develop proposed NRP policy elements — informed by reported safety events, existing policy, and ethical analysis.
Policy in this area changes. Verify current requirements against HRSA’s OPTN pages and OPTN public comment before acting. Nothing here is legal advice.
What we do: contract with OPOs and transplant centers to provide NRP perfusion coverage to a documented standard — and, for programs we do not staff, build and independently audit the governance around NRP.
What we do not do: perform organ recovery, direct clinical decisions, replace your ethics committee or legal counsel, or take a position on whether NRP should be offered. That decision belongs to your institution.
If your program decides against NRP, that is a legitimate outcome and we will help document the decision as rigorously as we would help run the service.