K Number
K243840
Device Name
Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001)
Manufacturer
Date Cleared
2025-03-26

(103 days)

Product Code
Regulation Number
876.5880
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is indicated for the in vitro flushing and continuous hypothermic machine perfusion of explanted abdominal organs.
Device Description
Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is a clear to straw-colored, sterile, non-pyrogenic solution for the in-vitro flushing and continuous perfusion of explanted abdominal organs. The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) has the same composition and indication for use as MaPerSol® Organ Preservation Solution. The solution is consistent with an extracellular solution, based on its sodium/potassium ratio and has a calculated potassium concentration of 25 mEq/L, a sodium concentration of 100 mEq/L, an osmolarity of 300 mosmol/kg, and a pH of approximately 7.4 at 20°C. The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is supplied in single use 1000mL solution bags, made from flexible PVC free material (e.g., laminated EVA film) with at least two integrated ports including ports for delivery and component addition. Each individual bag is enclosed in a protective outer overwrap bag. The solution is sterile and is intended for one single use.
More Information

No
The device is a preservation solution, and the description focuses on its chemical composition and packaging. There is no mention of any computational or analytical capabilities that would involve AI/ML.

No
The device is an organ preservation solution used for flushing and perfusing explanted organs, not for treating a disease or condition in a living patient.

No

The device is an organ preservation solution used for flushing and continuous hypothermic machine perfusion of explanted abdominal organs. Its purpose is to maintain organ viability, not to diagnose a condition or disease.

No

The device description clearly states it is a solution supplied in bags, which are physical components, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the in vitro flushing and continuous hypothermic machine perfusion of explanted abdominal organs. This describes a process performed outside the body, but it's a preservation and preparation step for organs intended for transplantation, not a diagnostic test performed on a sample to gain information about a patient's health.
  • Device Description: The description details a solution used to maintain the viability of organs. It doesn't describe a test or assay designed to detect or measure substances in a biological sample for diagnostic purposes.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples, detecting biomarkers, or providing information for diagnosis, monitoring, or screening.
  • Comparison to Predicate: The predicate device (MaPerSol® Solution) and reference device (EasiSlush® Cold Storage Solution) are also organ preservation solutions, not IVDs.

IVD devices are specifically designed to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health status. This device's function is to preserve organs, which is a different category of medical device.

N/A

Intended Use / Indications for Use

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is indicated for the in vitro flushing and continuous hypothermic machine perfusion of explanted abdominal organs.

Product codes

KDN, KDL

Device Description

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is a clear to straw-colored, sterile, non-pyrogenic solution for the in-vitro flushing and continuous perfusion of explanted abdominal organs. The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) has the same composition and indication for use as MaPerSol® Organ Preservation Solution.

The solution is consistent with an extracellular solution, based on its sodium/potassium ratio and has a calculated potassium concentration of 25 mEq/L, a sodium concentration of 100 mEq/L, an osmolarity of 300 mosmol/kg, and a pH of approximately 7.4 at 20°C.

The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is supplied in single use 1000mL solution bags, made from flexible PVC free material (e.g., laminated EVA film) with at least two integrated ports including ports for delivery and component addition. Each individual bag is enclosed in a protective outer overwrap bag. The solution is sterile and is intended for one single use.

The solution should be used only by medical healthcare staff, adequately trained according to established operating protocols.

The solution should be stored indoors at temperatures controlled between 2° and 25°C (36° and 77°F) until use. Excessive heat and freezing should be avoided. Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) should not be used if discolored or if obvious particulate matter, precipitates, or contamination are evident in the solution.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

abdominal organs

Indicated Patient Age Range

Not Found

Intended User / Care Setting

medical healthcare staff

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Non-clinical performance data included Biocompatibility testing, Sterility assurance (aseptic filling and membrane filtration), and Shelf Life claims (6 months). Verification and validation testing was done, and it was concluded that the subject device is substantially equivalent to the predicate and reference device, with risks addressed in a Risk Analysis.

Key Metrics

Not Found

Predicate Device(s)

K080432

Reference Device(s)

K191006

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5880 Isolated kidney perfusion and transport system and accessories.

(a)
Identification. An isolated kidney perfusion and transport system and accessories is a device that is used to support a donated or a cadaver kidney and to maintain the organ in a near-normal physiologic state until it is transplanted into a recipient patient. This generic type of device may include tubing, catheters, connectors, an ice storage or freezing container with or without bag or preservatives, pulsatile or nonpulsatile hypothermic isolated organ perfusion apparatus with or without oxygenator, and disposable perfusion set.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the logo for the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

March 26, 2025

Bridge to Life Mark Harper Compliance Manager 707 Skokie Boulevard, Suite 340 Northbrook, Illinois 60062

Re: K243840

Trade/Device Name: Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) Regulation Number: 21 CFR 876.5880 Regulation Name: Isolated Kidney Perfusion And Transport System And Accessories Regulatory Class: Class II Product Code: KDN. KDL Dated: December 13, 2024 Received: February 24, 2025

Dear Mark Harper:

We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

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Sincerely,

Image /page/2/Picture/3 description: The image shows the name "Maura Rooney" followed by "-S". The text is written in a clear, sans-serif font and is prominently displayed against a white background. The letters are large and easily readable.

Maura Rooney Assistant Director DHT3A: Division of Renal, Gastrointestinal, Obesity, and Transplant Devices OHT3: Office of Gastrorenal, ObGyn, General Hospital, and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) Number (if known) K243840

Device Name

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001)

Indications for Use (Describe)

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is indicated for the in vitro flushing and continuous hypothermic machine perfusion of explanted abdominal organs.

Type of Use (Select one or both, as applicable)
---------------------------------------------------

X Prescription Use (Part 21 CFR 801 Subpart D)

| Over-The-Counter Use (21 CFR 801 Subpart C)

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K243840: 510(k) Summary

1.0 SUBMITTER

Bridge to Life Ltd

707 Skokie Blvd. Ste. 340 Northbrook, IL 60062

Contact Person:Mark Harper
Phone:847-796-3070
Fax:803-753-9798
Email:m.harper@b2ll.com
Date Prepared:December 13th 2024

2.0 DEVICE

Proprietary Name :Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001)
Classification Name :Isolated kidney perfusion and transport system and accessories
Device Classification :Class II, 876.5880
Product Code :KDN, KDL

3.0 PREDICATE DEVICE

CompanyDeviceK NumberDate Cleared
Preservation Solutions, IncMaPerSol® SolutionK080432August 8, 2008

4.0 DEVICE DESCRIPTION

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is a clear to straw-colored, sterile, non-pyrogenic solution for the in-vitro flushing and continuous perfusion of explanted abdominal organs. The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) has the same composition and indication for use as MaPerSol® Organ Preservation Solution.

The solution is consistent with an extracellular solution, based on its sodium/potassium ratio and has a calculated potassium concentration of 25 mEq/L, a sodium concentration of 100 mEq/L, an osmolarity of 300 mosmol/kg, and a pH of approximately 7.4 at 20°C.

The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is supplied in single use 1000mL solution bags, made from flexible PVC free material (e.g., laminated EVA film) with at least two integrated ports including ports for delivery and component addition. Each individual bag is enclosed in a protective outer overwrap bag. The solution is sterile and is intended for one single use.

The solution should be used only by medical healthcare staff, adequately trained according to established operating protocols.

5

The solution should be stored indoors at temperatures controlled between 2° and 25°C (36° and 77°F) until use. Excessive heat and freezing should be avoided. Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) should not be used if discolored or if obvious particulate matter, precipitates, or contamination are evident in the solution.

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is substantially equivalent in composition, safety and efficacy to currently marketed MaPerSol® Solution, which was cleared by the US FDA in prior 510(k) submission K080432.

Table 1 provides information about the composition of Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001).

Componentg/LMmol/L
Adenine (free base)0.68g5
Calcium Chloride (dihydrate)0.068g0.5
Dextrose (+)1.80g10
Glutathione (reduced)0.92g3
HEPES (free acid)2.38 g10
Hydroxyethyl Starch50.0gN/A
Magnesium Gluconate1.13 g5
Mannitol5.4 g30
Potassium Phosphate (monobasic)3.4 g25
Ribose, D(-)0.75g5
Sodium Gluconate17.45 g80
Sodium Hydroxide0.70gN/A
Sterile WaterTo 1000 ml Volume

Table 1: Composition of Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001)

5.0 INDICATION FOR USE

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is indicated for the in-vitro flushing and continuous hypothermic machine perfusion of explanted abdominal organs.

6.0 COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

The following table provides a comparison of attributes between the subject, predicate and reference devices:

Subject DevicePredicate DeviceReference DeviceComparison
DeviceBelzer MPS® (UW Machine Perfusion Solution (BMPS-001))MaPerSol® Organ Preservation Solution (UW Machine Perfusion Solution)EasiSlush® Cold Storage Solution
510k NumberK243840K080432K191006
ManufacturerBridge to Life
707 Skokie Boulevard
Suite 340, Northbrook,
IL 60062Preservation Solutions, Inc., 980 Proctor Drive, Elkhorn, Wisconsin 53121Bridge to Life
707 Skokie Boulevard Suite
340, Northbrook, IL 60062
Classification &
Product Code876.5880; KDN876.5880; KDN876.5880; KDNSame
Device Regulation
DescriptionIsolated kidney
perfusion and transport
system and accessoriesIsolated kidney
perfusion and transport
system and accessoriesIsolated kidney perfusion
and transport system and
accessoriesSame
Common NameOrgan Preservation
SolutionOrgan Preservation
Solution0.9% Saline Slush SolutionSame
DESCRIPTION,
INDICATIONS,
& INTENDED
USE
Device DescriptionBTL's Belzer MPS®
(UW Machine
Perfusion Solution)
(BMPS-001) is a clear
to straw-colored
solution for the in-vitro flushing and
continuous machine
perfusion of explanted
abdominal organs.
This solution is
consistent with an
extracellular solution,
based on its
sodium/potassium
ratio. This solution has
a calculated potassium
concentration of 25
mEq/L, a sodium
concentration of 100
mEq/L, an osmolarity
of 300 mosmol/kg, and
a pH of approximately
7.4 at 20°C.
The solution is
packaged in 1-L bags.MaPerSol® Organ
Preservation Solution is
a clear to straw-colored
solution for the in-vitro
flushing and temporary
continuous perfusion
preservation of
explanted kidneys. This
solution is consistent
with an extracellular
solution, based on its
sodium/potassium ratio.
This solution has a
calculated potassium
concentration of 25
mEq/L, a sodium
concentration of 100
mEq/L, an osmolarity of
300 mosmol/kg, and a
pH of approximately 7.4
at 20°C.
The solution is
packaged in 1-Liter
bagsEasiSlush® is a clear,
colorless 0.9% Sodium
Chloride solution for
preparation of slushed
solution to provide
hypothermia during the
recovery, storage, and
transport of donor organs
for transplantation. The
solution is sterile, non-
pyrogenic, isotonic and is
contained in a 2L sterile,
flexible, non- PVC bag.Same
Subject, predicate and
reference devices are all
used as organ preservation
solutions. Devices are used
in the organ procurement
and transplant process per
standard organ
preservation practices.
Indications for UseBelzer MPS® (UW
Machine Perfusion
Solution) (BMPS-
  1. is indicated for
    the in-vitro flushing
    and continuous
    hypothermic
    machine perfusion of
    explanted abdominal
    organs. | MaPerSol® Organ
    Preservation Solution is
    indicated for in vitro
    flushing and continuous
    hypothermic machine
    perfusion of explanted
    kidneys. | EasiSlush slushed solution
    is intended for topical
    cooling of in-situ,
    abdominal donor organs
    during intraoperative
    recovery from the donor. It
    is also intended to maintain
    organ hypothermia during
    storage and transport to the
    transplant recipient.
    EasiSlush™ slushed
    solution is used to establish,
    and maintain hypothermia
    of donor organs during | Same
    Subject, predicate and
    reference devices are all
    used as organ preservation
    solutions. All devices are
    used at cold hypothermic
    temperatures, to slow
    biological deterioration in
    organs removed from their
    physiological environment
    per standard organ
    preservation practices.
    Specifically: |
    | | | | | |
    | Intended Use | Belzer MPS® (UW
    Machine Perfusion
    Solution) (BMPS-
  2. is intended for
    in-vitro flushing and
    continuous
    hypothermic
    machine perfusion of
    explanted abdominal
    organs. | MaPerSol® Organ
    Preservation Solution is
    intended for the in-vitro
    flushing and continuous
    hypothermic machine
    perfusion preservation
    of explanted kidneys. | EasiSlush™ slushed
    solution is intended for
    topical cooling of in-situ ,
    abdominal donor organs
    during intraoperative
    recovery from the donor. It
    is also intended to maintain
    organ hypothermia during
    storage and transport to the
    transplant recipient. | Subject device is similar to
    the predicate device in
    which they are both
    intended to flush, perfuse,
    or be left in the abdominal
    organ.
    Use #2 - Similar
    During organ perfusion,
    subject and predicate
    device create hypothermia,
    by cooling of organ.
    Use #3 - Similar
    Subject device is similar to
    the reference device in
    which both are used for
    organ preservation solution
    by maintaining organ
    hypothermia, by cooling
    the organ during
    preservation.
    Similar
    Subject device is an
    accessory to organ
    preservation solutions. All
    devices are intended for use
    at cold hypothermia, to
    slow biological
    deterioration in organs
    removed from their
    physiological environment
    per standard organ
    preservation practices. |
    | TECNOLOGICAL
    CHARACTERISTI
    CS | | | | |
    | Storage
    Temperature | 2° to 25° C | 2° to 25° C | 2° to 25° C | Same |
    | Pre-Cooling | Pre-cool solution prior
    to use
    (2° to 8° C) | Pre-cool solution prior
    to use
    (2° to 8° C) | Pre-cool solution prior to
    use (-4° to -15° C) | Similar
    Subject, predicate and
    reference solutions are all
    pre-cooled to hypothermic
    temperature ranges |
    | In-Situ Organ
    Cooling | Internal cooling of
    organ from perfusion
    of cold solution
    through organ blood
    vessels | Internal cooling of
    organ from perfusion of
    cold solution through
    organ blood vessels | External and internal
    cooling of organ | Same
    Subject, predicate and
    reference device are all for
    internal cooling of organ
    from perfusion of cold
    solution through organ
    blood vessels. |
    | Maintain Cold
    Organ Temperature
    During Storage and
    Transport | Directly cools organ
    external and internal
    surfaces via contact
    with cold solution. | Directly cools organ
    external and internal
    surfaces via contact with
    cold solution. | Directly cools the organ
    vasculature during
    hypothermic storage and
    transportation (not for
    continuous perfusion) to
    the patient. | Same
    Overall system
    performance by
    cooling/maintaining
    hypothermic temperature |
    | | | | | of organs are similar for
    all devices. |
    | Product State | Liquid – Solution | Liquid - Solution | Liquid - Solution | Same |
    | Composition | Adenine (free
    base) 0.68 g/L
    Calcium Chloride
    (dihydrate)
    0.068 g/L
    Dextrose (+)
    1.80 g/L
    Glutathione (reduced)
    0.92 g/L
    HEPES (free acid)
    2.38 g/L
    Hydroxyethyl Starch
    50.0 g/L
    Magnesium Gluconate
    1.13 g/L
    Mannitol
    5.4 g/L
    Potassium Phosphate
    (monobasic)
    3.4 g/L
    Ribose, D(-)
    0.75 g/L
    Sodium Gluconate
    17.45 g/L
    Sodium Hydroxide
    0.70 g/L
    Sterile Water for
    Injection
    To 1000 mL Volume | Adenine (free base)
    0.68 g/L
    Calcium Chloride
    (dihydrate)
    0.068 g/L
    Dextrose (+)
    1.80 g/L
    Glutathione (reduced)
    0.92 g/L
    HEPES (free acid)
    2.38 g/L
    Hydroxyethyl Starch
    50.0 g/L
    Magnesium Gluconate
    1.13 g/L
    Mannitol
    5.4 g/L
    Potassium Phosphate
    (monobasic)
    3.4 g/L
    Ribose, D(-)
    0.75 g/L
    Sodium Gluconate
    17.45 g/L
    Sodium Hydroxide
    0.70 g/L
    Sterile Water for
    Injection
    To 1000 mL
    Volume | Buffered saline solution.
    0.9% Sodium Chloride
    Irrigation USP | Same
    Subject and predicate
    devices are of the same
    exact chemical composition |
    | Osmolality | 300 mOsmol/kg | 300 mOsmol/kg | 300 mOsmol/kg | Same |
    | pH | Approximately 7.4 at
    20°C | Approximately 7.4 at
    20°C | 4.5-7.0 (per USP
    monograph for 0.9%
    Sodium Chloride
    Irrigation) | Same
    Subject and predicate
    devices have the same pH
    specifications |
    | Fluid Volume | 1,000 ml | 1,000 ml | 1,250ml | Same
    Subject device is available
    in same volume as the
    predicate device. |
    | Single Use Only | Yes | Yes | Yes | Same |
    | Primary Container | PVC-Free Bag | PVC-Free Bag | PVC-Free Bag | Equivalent |
    | Protecting
    Overwrap Bag | Yes | Yes | Yes | Same |
    | Shelf Life | 6 Months | 24 Months | 24 Months | Same. Shelf life stability
    study is on-going to meet 24
    months shelf life. |
    | Pyrogenicity | Non-Pyrogenic | Non-Pyrogenic | Non-Pyrogenic | Same |
    | Sterility | Sterility assured via
    0.2 μ and two 0.1 μ
    membrane filtrations | Sterility assured via 0.1
    μ membrane filtration | Terminally sterilized | Same |
    | Sterilization | Aseptic
    processing and
    sterile filtration | Aseptic processing and
    sterile filtration | Terminal gamma irradiation | Same
    All devices are sterile. |
    | Biocompatibility | Biocompatible in
    accordance with ISO
    10993-1/2/5/10/12. | Biocompatible in
    accordance with ISO
    10993-1/2/5/10/12. | Biocompatible in
    accordance with ISO
    10993-1/2/5/10/12. | Equivalent |
    | Sterile
    Dispensing/
    Administration | Fluid is dispensed via
    sterile port on bag. | Fluid is dispensed via
    sterile port on bag. | Sterile bag is cut with sterile
    instrument and contents
    dispensed to desired
    location. | Similar |
    | Bag Connections | Fluid port provided for
    organ flushing | Fluid port provided
    for organ flushing | None | Same
    Subject and predicate device
    are same.
    Different
    Reference device is not
    intended for organ flushing,
    so no port is provided. |

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7

8

9

NON-CLINICAL PERFORMANCE DATA 7.0

7.1. Biocompatibility

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) has been demonstrated as substantially equivalent in biocompatibility to the predicate device via testing and biological risk assessment, such that it is safe for its intended use.

7.2 Sterilitv

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is aseptically filled and sterility assured via 0.2 µ and two 0.1 µ membrane filtration.

7.3 Shelf Life

Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) has a shelf life claim of 6 months.

8.0 DESIGN CONTROL SUMMARY

All procedural Design Controls were followed, and all design control elements were satisfied.

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9.0 SUMMARY OF VERIFICATION & VALIDATION

Verification and validation testing was done on the Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001). The subject device is substantially equivalent to the predicate and reference device. Any risks to the overall system were addressed in the Risk Analysis. Concerns or risks identified were mitigated by the actual proper use and function Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) indicated in the Instructions for Use. It is appropriate to conclude that Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is substantially equivalent to the predicate device K080432.

10.0 CONCLUSION

The subject and predicate devices have the same intended use and are substantially equivalent in technological characteristics and performance (same composition). The Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is safe and effective as predicate and reference devices. The non-clinical data supports and demonstrates the safety of the device.

The conclusion is that Belzer MPS® (UW Machine Perfusion Solution) (BMPS-001) is substantially equivalent to the legally marketed MaPerSol® Solution and therefore should have clearance for premarket activities in the United States.