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Milestones and Basic Principles.

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    Organ preservation is crucial for transplant success due to donor shortages. This review covers static and dynamic cooling methods, preservation solutions, and future insights from hibernators for better organ outcomes.

    Area of Science:

    • Transplantation immunology
    • Organ preservation science
    • Cellular ischemia research

    Background:

    • Increasing organ donor shortages necessitate expanded eligibility criteria for organ donation.
    • Understanding the pathophysiology of cell ischemia and protection is vital for successful organ transplantation.
    • Effective organ preservation directly impacts graft function, survival, and prevents chronic rejection.

    Purpose of the Study:

    • To review current organ preservation techniques and solutions.
    • To discuss the historical development and future perspectives in organ preservation.
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    Main Methods:

    • Review of historical and current organ preservation solutions (e.g., EuroCollins, UW solution, Custodiol®, Celsior).

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  • Discussion of static (simple cold storage) and dynamic (hypothermic machine perfusion) cooling approaches.
  • Analysis of cellular ischemia and protection mechanisms, including cytokine roles and oxidative stress.

    • Main Results:

    • Static cold storage is suitable for all organs, while hypothermic machine perfusion is primarily for kidneys and liver.
    • Different organs exhibit varying tolerances to warm and cold ischemia.
    • Established preservation solutions have evolved, with newer options available.

    Conclusions:

    • Optimized organ preservation is essential for successful transplants, especially with expanded donor criteria.
    • Hypothermic machine perfusion offers dynamic advantages for specific organs.
    • Future advancements, potentially inspired by hibernators, may revolutionize human organ preservation.