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HERO ID
6992642
Reference Type
Journal Article
Title
Trends in organ preservation
Author(s)
Mclaren, AJ; Friend, PJ
Year
2003
Is Peer Reviewed?
1
Journal
Transplant International
ISSN:
0934-0874
Volume
16
Issue
10
Page Numbers
701-708
Language
English
PMID
14530855
DOI
10.1111/j.1432-2277.2003.tb00227.x
Web of Science Id
WOS:000186684300001
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; preservation
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