Preservation of intra-abdominal organs for transplantation

The history of clinical organ transplantation and its development in routine surgical practice has been packed into the last 40 years and is encompassed by the careers of many of the pioneers of transplantation. Improved immunosuppression, surgical, anesthetic, and postoperative management have transformed results and allowed many new organs to be transplanted. Progress in preserving organs for transplantation has lagged behind the other advances in transplantation. Until the introduction of UW solution, no major progress was made after the introduction of machine perfusion preservation by Dr. Belzer in 1967 and that of simple cold storage by Dr Collins in 1969. This solution was developed at the University of Wisconsin and has allowed extended simple cold storage of the pancreas, liver, kidney, and more recently, the small bowel prior to transplantation. The UW solution represents a good answer to the problem of short-term storage of organs for transportation and early reimplantation, but equally important, it has also stimulated renewed research interest in this area. A more profound understanding of the events occurring during hypothermic storage and subsequent reperfusion is needed if further advances are to be made. It is anticipated that if long-term organ storage is to be achieved this will require a perfusion preservation system that allows the maintenance of essential metabolic processes.