Organ preservation and viability in kidney and liver transplantationMaathuis, M. H. J., 2008, s.n.. 192 p.
Research output: Thesis › Thesis fully internal (DIV) › Academic
Organ preservation for transplantation. The easy way or best method? Kidney and liver transplantations are routinely performed nowadays to treat end stage organ diseases. However, the increasing gap between demand and supply, has necessitated the transplantation community to expand donor criteria and accept donor organs which sustained more damage. Organ preservation should maintain organ viability after an organ has been disconnected from the circulation in the donor. At this moment static cold storage (4°C) using the University of Wisconsin (UW) solution is the most widely used method of organ preservation. Improving organ preservation might be a successful strategy to transplant damaged organs with excellent function after transplantation. A novel and now clinically available preservation solution (IGL-1) was studied in an animal model but did not show any advantage over the UW solution. An alternative method for organ preservation is hypothermic machine perfusion (HMP). Using this method, the organ is connected to a perfusion device. The Groningen Machine Perfusion system was studied in a porcine model and improved kidney and liver preservation. In a clinical trial, deceased donor kidneys demonstrated a better function after transplantation following HMP preservation when compared to CS. Even more improvement can be expected from normothermic (37°C) machine preservation. Due to the complexity of the technique, more research is necessary before clinical application can be considered. The growing waiting lists and the changing donor pool call for better preservation techniques. Hypothermic machine perfusion, and may be in the future normothermic machine perfusion, are promising preservation techniques to transplant more damaged organs with adequate outcome.
- Proefschriften (vorm), Niertransplantatie, Kwaliteit , Organen (biologie), urologie
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