Skip to main content

Organ Preservation

  • Chapter
  • First Online:
Transplantation Surgery

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

Abstract

Since the first speculations about organ preservation over 200 years ago, there has been enormous progress in this field. Progressin solid-organ transplantation from the level of experimental studies to becoming the criterion standard is undoubtedly due to advances in organ retrieval from deceased donors and their preservation. The objective of the preservation process is to preserve organ function and cellular integrity until the time of transplant. Because the number of patients on wait lists has increased and because of the limited organ and tissue pool, marginal grafts from deceased donors have become more frequently used. In this regard, organ and tissue preservation techniques are of even greater importance for outcomes attained with marginal grafts. In this chapter, we will review and discuss injury mechanisms during the organ preservation process, the history of organ preservation techniques and solutions and currently used practices, and future perspectives. These techniques have initiated in-depth studies about advanced graft preservation, viability assessment, and most importantly repair and regeneration. Studies on organ preservation continue intensively in many organ transplant centers worldwide, with the basic aim of prolonging preservation time without injuring the organ.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Demirbaş A. Organ prezervasyonu. In: Haberal M, editor. Doku ve Organ Transplantasyonları. Ankara: Haberal Eğitim Vakfı; 1993. p. 69–75.

    Google Scholar 

  2. Haberal M, Emiroğlu R. Karaciğer transplantasyonu. In: Gulay H, editor. Temel ve Sistematik Cerrahi. İzmir: Güven Kitapevi; 2005. p. 711–38.

    Google Scholar 

  3. Brodie T. The perfusion of surviving organs. J Physiol. 1903;29:266–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Le Gallois M. Experiments on the principle of life, and particularly on the principle of the motions of the heart, and on the seat of this principle: including the report made to the first class of the Institute, upon the experiments relative to the motions of the heart. Philadelphia, PA: M. Thomas; 1813.

    Book  Google Scholar 

  5. Carrel A, Lindbergh CA. The culture of whole organs. Science. 1935;81:621–3.

    Article  CAS  PubMed  Google Scholar 

  6. Carrel A. The culture of whole organs: I. technique of the culture of the thyroid gland. J Exp Med. 1937;65:515–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Collins GM, Bravo-Shugarman M, Terasaki PI. Kidney preservation for transportation. Initial perfusion and 30 hours’ icestorage. Lancet. 1969;2:1219–22.

    Article  CAS  PubMed  Google Scholar 

  8. Ueda Y, Todo S, Imventarza O, Furukawa H, Oks A, Wu YM, et al. The UW solution for canine kidney preservation. Its specific effect on renal hemodynamics and microvasculature. Transplantation. 1989;48:913–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Taylor MJ, Baicu SC. Current state of hypothermic machine perfusion preservation of organs: the clinical perspective. Cryobiology. 2010;60(Suppl 1):20–35.

    Article  Google Scholar 

  10. Belzer FO, Southard JH. Principles of solid-organ preservation by cold storage. Transplantation. 1988;45(4):673–6.

    Article  CAS  PubMed  Google Scholar 

  11. Calne RY, Pegg DE, Pryse-Davies J, Brown FL. Renal preservation by ice-cooling: an experimental study relating to kidney transplantation from cadavers. Br Med J. 1963;2:651–5.

    CAS  PubMed  Google Scholar 

  12. Vreugdenhil PK, Belzer FO, Southard JH. Effect of cold storage on tissue and cellular glutathione. Cryobiology. 1991;28:143–9.

    Article  CAS  PubMed  Google Scholar 

  13. Mühlbacher F, Langer F, Mittermayer C. Preservation solutions for transplantation. Transplant Proc. 1999;31(5):2069–70.

    Article  PubMed  Google Scholar 

  14. Collins GM, Hartley LC, Clunie GJ. Kidney preservation for transportation. Experimental analysis of optimal perfusate composition. Br J Surg. 1972;59:187–9.

    Article  CAS  PubMed  Google Scholar 

  15. Starzl TE, Hakala TR, Shaw BW Jr, Hardesty RL, Rosenthal TJ, Griffith BP, et al. Flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet. 1984;158:223–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Arnault I, Bao YM, Dimicoli JL, et al. Combinedeffect of fasting and alanine on liver function recovery after cold ischemia. Transplant Int. 2002;15:89–95.

    Article  CAS  Google Scholar 

  17. Pienaar BH, Lindell SL, Van Gulik T, Southard JH, Belzer FO. Seventy-two hour preservation of the canine liver by machine perfusion. Transplantation. 1990;49(2):258–60.

    Article  CAS  PubMed  Google Scholar 

  18. Guibert EE, Petrenko AY, Balaban CL, Somov AY, Rodriguez JV, Fuller BJ. Organ preservation: current concepts and new strategies for the next decade. Transfus Med Hemother. 2011;38(2):125–42.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Moray G, Sevmis S, Karakayali FY, Gorur SK, Haberal M. Comparison of histidine-tryptophan-ketoglutarate and University of Wisconsin in living-donor liver transplantation. Transplant Proc. 2006;38:3572–5.

    Article  CAS  PubMed  Google Scholar 

  20. Jing L, Yao L, Zhao M, Peng LP, Liu M. Organ preservation: from the past to the future. Acta Pharmacol Sin. 2018;39(5):845–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. O’Callaghan JM, Morgan RD, Knight SR, Morris PJ. The effect of preservation solutions for storage of liver allografts on transplant outcomes. Ann Surg. 2014;260:46–55.

    Article  PubMed  Google Scholar 

  22. Haberal M, Moray G, Bilgin N, Karakayali H, Arslan G, Büyükpamukçu N. Ten-year survival after a cold-ischemia time of 111 hours in the transplanted kidney. Transplant Proc. 1996;28(4):2333.

    CAS  PubMed  Google Scholar 

  23. ANZOD Registry. Australia and New Zealand Organ Donation Registry Report 2015. http://www.anzdata.org.au/anzod/v1/ar-2015.html. Accessed 4 Jun 2016.

  24. Aydin G, Okiye SE, Zincke H. Successful 24-hour preservation of the ischemic canine kidney with Euro-Collins solution. J Urol. 1982;128:1401–3.

    Article  CAS  PubMed  Google Scholar 

  25. Jamieson RW, Friend PJ. Organ reperfusion and preservation. Front Biosci. 2008;13:221–35.

    Article  CAS  PubMed  Google Scholar 

  26. Okada Y, Kondo T. Preservation solution for lung transplantation. Gen Thorac Cardiovasc Surg. 2009;57:635–9.

    Article  PubMed  Google Scholar 

  27. Voigt MR, DeLario GT. Perspectives on abdominal organ preservation solutions: a comparative literature review. Prog Transplant. 2013;23:383–91.

    Article  PubMed  Google Scholar 

  28. Karam G, Compagnon P, Hourmant M, Despins P, Duveau D, Noury D, et al. A single solution for multiple organ procurement and preservation. Transpl Int. 2005;18:657–63.

    Article  PubMed  Google Scholar 

  29. Stewart ZA, Cameron AM, Singer AL, Montgomery RA, Segev DL. Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival in deceased donor livers, especially those donated after cardiac death. Am J Transplant. 2009;9(2):286–93.

    Article  CAS  PubMed  Google Scholar 

  30. El-Wahsh M. Liver graft preservation: an overview. Hepatobiliary Pancreat Dis Int. 2007;6(1):12–6.

    CAS  PubMed  Google Scholar 

  31. Groenewoud AF, Thorogood J. Current status of the Eurotransplant randomized multicenter study comparing kidney graft preservation with histidine tryptophan-ketogluterate, University of Wisconsin, and Euro-Collins solutions. The HTK Study Group. Transplant Proc. 1993;25:1582–5.

    CAS  PubMed  Google Scholar 

  32. Latchana N, Peck JR, Whitson BA, Henry ML, Elkhammas EA, Black SM. Preservation solutions used during abdominal transplantation: current status and outcomes. World J Transplant. 2015;5(4):154–64.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Catena F, Coccolini F, Montori G, Vallicelli C, Amaduzzi A, Ercolani G, et al. Kidney preservation: review of present and future perspective. Transplant Proc. 2013;45:3170–7.

    Article  CAS  PubMed  Google Scholar 

  34. Feng L, Zhao N, Yao X, et al. Histidine-tryptophan-ketoglutarate solution vs. University of Wisconsin solution for liver transplantation: a systematic review. Liver Transpl. 2007;13(8):1125–36.

    Article  PubMed  Google Scholar 

  35. Ringe B, Braun F, Moritz M, et al. Safety and efficacy of living donor liver preservation with HTK solution. Transplant Proc. 2005;37(1):316–9.

    Article  CAS  PubMed  Google Scholar 

  36. Rentsch M, Post S, Palma P, Lang G, Menger MD, Messmer K. Anti-ICAM–1 blockade reduces postsinusoidal WBC adherence following cold ischemia and reperfusion, but does not improve early graft function in rat liver transplantation. J Hepatol. 2000;32:821–8.

    Article  CAS  PubMed  Google Scholar 

  37. Lynch RJ, Kubus J, Chenault RH, Pelletier SJ, Campbell DA, Englesbe MJ. Comparison of histidine-tryptophan-ketoglutarate and University of Wisconsin preservation in renal transplantation. Am J Transplant. 2008;8(3):567–73.

    Article  CAS  PubMed  Google Scholar 

  38. Mangus RS, Fridell JA, Vianna RM, Milgrom MA, Chestovich P, Chihara RK, Tector AJ. Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in extended criteria liver donors. Liver Transpl. 2008;14(3):365–73.

    Article  PubMed  Google Scholar 

  39. Rayya F, Harms J, Martin AP, Bartels M, Hauss J, Fangmann J. Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in adult liver transplantation. Transplant Proc. 2008;40(4):891–4.

    Article  CAS  PubMed  Google Scholar 

  40. Terasaki PI, McClelland JD, Yuge J, Cecka JM, Gjertson DW, Takemoto S, Cho YW.Advances in kidney transplantation: 1985–1995. Clin Transpl. 1995:487–501.

    Google Scholar 

  41. Montiel-Casado MC, Pérez-Daga JA, Blanco-Elena JA, Aranda-Narváez JM, Sánchez-Pérez B, Cabello-Díaz M, Ruiz-Esteban P, León-Díaz FJ, Gutiérrez-de la Fuente C, Santoyo-Santoyo J. Pancreas preservation with viaspan, celsior, and custodiol solutions: an initial experience. Transplant Proc. 2016;48(9):3040–2.

    Article  CAS  PubMed  Google Scholar 

  42. Belzer FO, May R, Berry M, Lee JC. Short term preservation of porcine livers. J Surg Res. 1970;10:55–61.

    Article  CAS  PubMed  Google Scholar 

  43. Fontes P, Lopez R, van der Plaats A, Vodovotz Y, Minervini M, Scott V, et al. Liver preservation with machine perfusion and a newly developed cell-free oxygen carrier solution under subnormothermic conditions. Am J Transplant. 2015;15:381–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Guarrera JV, Henry SD, Samstein B, Odeh-Ramadan R, Kinkhabwala M, Goldstein MJ, et al. Hypothermic machine preservation in human liver transplantation: the first clinical series. Am J Transplant. 2010;10:372–81.

    Article  CAS  PubMed  Google Scholar 

  45. Humphries AL, Russell R, Stoddard LD, Moretz WH. Successful five-day kidney preservation. Perfusion with hypothermic, diluted plasma. Investig Urol. 1968;5:609–18.

    Google Scholar 

  46. Belzer FO, Ashby BS, Dunphy JE. 24-hour and 72-hour preservation of canine kidneys. Lancet. 1967;2:536–8.

    Article  CAS  PubMed  Google Scholar 

  47. Henry SD, Guarrera JV. Protective effects of hypothermic ex vivo perfusion on ischemia/reperfusion injury and transplant outcomes. Transplant Rev. 2012;26:163–75.

    Article  Google Scholar 

  48. Nakajima D, Chen F, Yamada T, Sakamoto J, Osumi A, Fujinaga T, et al. Hypothermic machine perfusion ameliorates ischemia-reperfusion injury in rat lungs from non-heart-beating donors. Transplantation. 2011;92:858–63.

    Article  PubMed  Google Scholar 

  49. Nakajima D, Chen F, Okita K, Motoyama H, Hijiya K, Ohsumi A, et al. Reconditioning lungs donated after cardiac death using short-term hypothermic machine perfusion. Transp J. 2012;94:999–1004.

    Article  Google Scholar 

  50. Michel SG, LaMuraglia GM II, Madariaga MLL, Titus JS, Selig MK, Farkash EA, et al. Twelve-hour hypothermic machine perfusion for donor heart preservation leads to improved ultrastructural characteristics compared to conventional cold storage. Ann Transplant. 2015;20:461–8.

    Article  CAS  PubMed  Google Scholar 

  51. Steen S, Liao Q, Wierup PN, Bolys R, Pierre L, Sjöberg T. Transplantation of lungs from non-heart-beating donors after functional assessment ex vivo. Ann Thorac Surg 2003;76:244–52; discussion 252.

    Google Scholar 

  52. Erasmus ME, Fernhout MH, Elstrodt JM, Rakhorst G. Normothermic ex vivo lung perfusion of non-heart-beating donor lungs in pigs: from pretransplant function analysis towards a 6-h machine preservation. Transpl Int. 2006;19:589–93.

    Article  PubMed  Google Scholar 

  53. Cypel M, Yeung JC, Hirayama S, Rubacha M, Fischer S, Anraku M, et al. Technique for prolonged normothermic ex vivo lung perfusion. J Hear Lung Transpl. 2008;27:1319–25.

    Article  Google Scholar 

  54. Ravikumar R, Jassem W, Mergental H, Heaton N, Mirza D, Perera MTPR, et al. Liver transplantation after ex vivo normothermic machine preservation: a phase 1 (first-in-man) clinical trial. Am J Transplant. 2016;16:1779–87.

    Article  CAS  PubMed  Google Scholar 

  55. Bejaoui M, Pantazi E, Folch-Puy E, Baptista PM, García-Gil A, Adam R, et al. Emerging concepts in liver graft preservation. World J Gastroenterol. 2015;21:396–407.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Hoyer DP, Gallinat A, Swoboda S, Wohlschläger J, Rauen U, Paul A, et al. Subnormothermic machine perfusion for preservation of porcine kidneys in a donation after circulatory death model. Transpl Int. 2014;27:1097–106.

    Article  PubMed  Google Scholar 

  57. Adams TD, Patel M, Hosgood SA, Nicholson ML. Lowering perfusate temperature from 37 °C to 32 °C diminishes function in a porcine model of ex vivo kidney perfusion. Transplant Direct. 2017;3:e140.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Schopp I, Reissberg E, Lüer B, Efferz P, Minor T. Controlled rewarming after hypothermia: adding a new principle to renal preservation. Clin Transl Sci. 2015;8:475–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Hoyer DP, Mathé Z, Gallinat A, Canbay AC, Treckmann JW, Rauen U, et al. Controlled oxygenated rewarming of cold stored livers prior to transplantation. Transplantation. 2016;100:147–52.

    Article  CAS  PubMed  Google Scholar 

  60. Hoyer DP, Paul A, Minor T. Prediction of hepatocellular preservation injury immediately before human liver transplantation by controlled oxygenated rewarming. Transplant Direct. 2017;3:e122.

    Article  PubMed  Google Scholar 

  61. Bender DA. Nutritional biochemistry of the vitamins. Cambridge: Cambridge University Press; 2003.

    Book  Google Scholar 

  62. Kaths JM, Echeverri J, Goldaracena N, Louis KS, Chun YM, Linares I, et al. Eight-hour continuous normothermic ex vivo kidney perfusion is a safe preservation technique for kidney transplantation: a new opportunity for the storage, assessment, and repair of kidney grafts. Transplantation. 2016;100:1862–70.

    Article  CAS  PubMed  Google Scholar 

  63. Jing L, Yao L, Zhao M, Peng L-p, Liu M. Organ preservation: from the past to the future. Acta Pharmacol Sin. 2018;39:845–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mehmet Haberal .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kirnap, M., Haberal, M. (2021). Organ Preservation. In: Hakim, N., Haberal, M., Maluf, D. (eds) Transplantation Surgery. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-55244-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-55244-2_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-55243-5

  • Online ISBN: 978-3-030-55244-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics