Trends in organ preservation

Abstract

Organ preservation aims to provide a viable graft with primary function post-transplant. The current basis of preservation for transplantation is static cold storage using specific preservation solutions which minimise cellular swelling and membrane pump activity, thus maintaining cellular ATP levels. The current organ shortage and consequent expansion of donor criteria places even greater reliance on minimising graft injury during preservation. This review focuses on current and future advances in preservation technology. The key areas of advance are additives to preservation solutions, alternatives/ adjuncts to preservation solutions including perfluorocarbons. A major area of advance is in the modulation of organs during the storage period. This may be achieved by biochemical additives or genetic manipulation. Machine perfusion technology is improving, and this is discussed together with the recent concept of warm (normothermic) perfusion as an alternative means of preservation. The authors provide an overview over the current methods of organ preservation. Cold storage, effective in the short-term is insufficient for marginal organs, does not allow assessment of viability markers, and provokes ischaemic injury. Potential strategies for minimising ischaemic injury include additives to preservation solutions; the two-layer method with perfluorcarbons and UW solution-at present limited to pancreas preservation; organ modulation; organ preconditioning and genetic modification of organs. In particular, the authors illuminate the potential in a reappraisal of the concept of normothermic perfusion.Keywords Transplantation . PreservationAbbreviations HSP Heat shock proteins . ICAM-I Intercellular adhesion molecule-1 . I/R Ischaemia reperfusion . PFC Perflurocarbon . U W University of Wisconsin solutionThe aims of presewation extended preservation times. This has provided important logistic benefits including, in the case of kidney The purpose of organ preservation in the context of transplantation, the institution of HLA-based organ transplantation is to deliver a viable graft to a recipient sharing across geographical boundaries. However there which will exhibit primary function. Improvements in is an increasing recognition that the limits of convenhypothermic preservation solutions have allowed tional preservation have been reached, and future

Efficient and Durable Gene Transfer to Transplanted Heart Using Adeno-associated Virus 9 Vector

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The Effect of Ovary Storage and In Vitro Maturation on mRNA Levels in Bovine Oocytes; A Possible Impact of Maternal ATP1A1 on Blastocyst Development in Slaughterhouse-derived Oocytes

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Curcumin reduces cold storage-induced damage in human cardiac myoblasts

“…For this reason, special cold storage solutions have been developed with the aim to preserve organ function and viability. They usually contain high potassium to prevent loss of potassium-ATPase activity and include a colloid to reduce cell swelling (McLaren and Friend, 2003). One such solution, named Celsior, has been recently introduced in heart transplantation with the aim of combining general principles of hypothermic storage with the specific needs of the myocardium (Michel et al, 2002).…”