Scientific basis of organ preservation

To review the basic mechanisms involved during hypothermia and reperfusion, with special attention paid to efforts being made in refining solutions and the molecular characterization of cells during preservation.

Several graft-related molecules have been identified as correlating with early graft dysfunction and/or poor outcome in the immediate posttransplant period. Also, different inhibitors have been utilized to ameliorate the preservation-induced injury, alone or in combination with different preservation solutions.

Preservation-induced injury is a major contributing factor to early graft dysfunction in organ recipients. The success of organ transplantation is critically dependent on the quality of the donor organ. Donor-organ quality, in turn, is determined by a variety of factors, including donor age, donor management prior to organ procurement, the duration of hypothermic storage, and perfusion techniques utilized to protect organs from ischemia/reperfusion injury, which in turn cause a dramatic reprogramming of cell metabolism during organ transplantation. The expression of a number of inflammatory genes has been associated with early graft dysfunction and/or poor outcome in the immediate postoperative period. Some therapeutic manipulations have been demonstrated to be of significance in attaining near-normal organ function after transplantation.