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Preservation by simple hypothermia

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Procurement, Preservation and Allocation of Vascularized Organs

Abstract

The major importance of cold in extracorporeal storage of transplantable vascularized organs was recognized early in the history of transplantation. Hypothermia was first applied by simple surface cooling of the organ. Cooling was enhanced by flushing the blood from the organ by a chilled preserving solution — such solutions initially mimicked extracellular fluid or plasma. A major breakthrough occurred in the late 1960s when Collins demonstrated that a crystalloid preserving solution containing high concentrations of potassium and phosphate (an ‘intracellular’ solution) improved preservation markedly [1]. Subsequent modifications and alternatives to Collins’ solution showed that several flushing solutions, widely varying in their content, could give approximately equivalent results for simple hypothermic storage of kidneys and other vascularized organs [2]. Search for an optimal flushing solution applicable to all organs received a further major stimulus in the late 1980s with the advent of Belzer’s University of Wisconsin (UW) solution. This multi-component solution extended storage times even further, particularly of pancreas and liver, and was also applicable to kidney, heart, lung and small bowel grafts [3].

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Authors
  1. Vernon Marshall
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Editors and Affiliations

  1. Department of Transplantation, California Pacific Medical Center, San Francisco, California, USA

    G. M. Collins

  2. Transplantation Pavillon V, Hôpital Edouard Herriot, Lyon, France

    J. M. Dubernard

  3. Division of Transplant Surgery, Department of Surgery, Klinikum Grosshadern, University of Munich, Munich, Germany

    W. Land

  4. Eurotransplant Foundation, Leiden, The Netherlands

    G. G. Persijn

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Marshall, V. (1997). Preservation by simple hypothermia. In: Collins, G.M., Dubernard, J.M., Land, W., Persijn, G.G. (eds) Procurement, Preservation and Allocation of Vascularized Organs. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5422-2_13

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  • DOI: https://doi.org/10.1007/978-94-011-5422-2_13

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  • Print ISBN: 978-94-010-6280-0

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