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Basic considerations in organ perfusion physiology

Zimmerman, Michael A.; Martin, Alicia; Hong, Johnny C.

Current Opinion in Organ Transplantation: June 2016 - Volume 21 - Issue 3 - p 288–293
doi: 10.1097/MOT.0000000000000312
REVIEW
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Purpose of review Owing to a severe shortage of organs for patients with end-stage diseases, novel techniques in organ preservation and perfusion need to be studied and reviewed to increase the number of available organs for transplant. Many patients will die while waiting for an organ. To make organs from extended-criteria donors feasible, optimal conditions for pulsatile perfusion and the potential for organ reconditioning at implantation need to be addressed.

Recent findings Many techniques in organ preservation and perfusion are being studied. Several laboratories are studying the effects of temperature for organ perfusion. Two areas being studied are hypothermic and normothermic machine perfusion. In the area of organ preservation, new solutions are being studied such as a substrate-enriched, oxygen-saturated, and leukocyte-depleted perfusate to help with organ quality.

Summary Even with the strides being made in organ preservation and perfusion, there are still many unanswered questions. More studies will need to be done to find the optimal conditions for duration of perfusion in the cold phase, optimal perfusion solution, degree of oxygenation, and the addition of pharmacologic agents, to improve organ function and expand the organ pool.

Department of Surgery, Division of Transplant Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

Correspondence to Michael A. Zimmerman, MD, Department of Surgery, Division of Transplant Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Suite E5700, Milwaukee, WI 53226, USA. Tel: +1 414 955 6920; fax: +1 414 955 6222; e-mail: mzimmerman@mcw.edu

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