[The use of preservation solutions in renal transplantation]

Return of renal function appears to at least partly determine long-term graft survival. The increasingly frequent use of transplants derived from "borderline" donors requires optimization of organ preservation conditions and return of function partly depends on the quality of the preservation solution. A growing number of preservation solutions of very variable quality are now used in France without even a minimum of information concerning their characteristics and expected results. This article, largely inspired by the conclusions of a working party formed at the request the Biomedicine Agency, reviews the published experimental and clinical studies on the essential characteristics justifying the use of preservation solutions. Eurocollins and all other solutions not containing impermeants or colloid give less favourable clinical results and should no longer be used for multi-organ harvesting. However due to the lack of published clinical data, no preservation solution can be considered to be better than another, although experimental and clinical arguments are in favour of the use of extracellular solutions using PEG as colloid. As the modalities of use of preservation solutions are very variable, the authors also provide several recommendations designed to harmonize transplantation practices.