Organ preservation: what is it about?

Nowadays, transplantation is considered the most suitable alternative and the only option that does not compromise liver function, for patients suffering from terminal renal failure . The General Surgery expert explains what it is

 

In Italy, liver and kidney transplants are continuously increasing, a factor attributed to the growth of donation activity.

The good result of organ transplants is favored by the development of new surgical procedures and organ preservation techniques (static preservation in hypothermia) as well as by the discovery of new immunosuppressive agents, i.e. molecules that inhibit the immune response.

What is static hypothermic storage?

It is a procedure that involves washing and immersing the organ in a preservation solution at 4 ° C, in this way it reduces the metabolism, the ability to generate energy and the need for oxygen by the organ, subjected in each case to damage that grows as a function of the immersion time in cold ischemia.

Can it be used for all types of organs?

No. Even if considered the most widely used conservation technique, it is not recommended for marginal organs, that is, all those organs that do not fully meet the selection requirements, precisely because of the risk of failure to recover and functionality of the organ itself, after a transplant.

Are there other types of organ preservation techniques?

  • Continuous dynamic preservation is another preservation system. It concerns the conservation of a kidney for up to three days using a Machine Perfusion, or a hypothermic portal and arterial perfusion system with the help of oxygenated plasma and fluorocarbon emulsion, in order to determine continuous oxygenation in organ transplants. .
  • Normothermic perfusion of liver or kidney involves storage at a temperature of 35-37 ° C and aims to reduce cell damage from anoxia and / or hypoxia (partial or total oxygen deficiency in the body). Therefore normothermic perfusion keeps the organ metabolically active, physiologically repairing it from the ischemic cell damage suffered thanks to the use of oxygenated blood .
  • Finally, oxygenated hypothermic perfusion or cold hypothermic preservation allows to improve the clinical point of view of the organ and decreases the risk of slowing down in the resumption of its functions following transplantation. Furthermore, it aims to reduce the temperature of the energy metabolism , even if in this case, there is a persistent hypothermic condition and the oxygen demand does not exceed 10%.

 

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