ORGAN PRESERVATION

Organ preservation is the supply line for organ transplantation. Curre ntly, the liver, pancreas, and kidney can be successfully preserved fo r up to two days by flushing the organs with the University of Wiscons in (UW) organ preservation solution and storing them at hypothermia (0 -5 degrees C). The UW solution is effective because it uses a number o f cell impermeant agents (lactobionic acid, raffinose, hydroxyethyl st arch) that prevent the cells from swelling during cold ischemic storag e. Additionally, the UW solution contains glutathione and adenosine, a gents that may stimulate recovery of normal metabolism upon reperfusio n by augmenting the antioxidant capacity of the organs (glutathione) o r by stimulating high-energy phosphate generation (adenosine) upon rep erfusion. Although this method of organ preservation is effective, som e organs (5-15% of Livers and 20-30% of kidneys) do not function well upon transplant. Injury may be preservation related but may also resul t from donor and recipient factors that render the organs more suscept ible to preservation damage. Results with continuous perfusion of kidn eys in the clinics show a reduction in preservation/reperfusion damage . This may be a more appropriate preservation method than cold storage . In this chapter we discuss the development and use of the UW solutio n and present clinical results. Although intraabdominal organs are wel l preserved at present, intrathoracic organs (lungs and heart) are les s well preserved, and better methods for preservation of these organs are needed for increased use of lung and heart transplantation.