The use of machine perfusion in solid organ transplantation has developed tremendously worldwide in recent years. Although the number of randomized controlled trials in the field of organ preservation is still limited, machine perfusion has been shown to be superior to static cold storage of donor organs. Various devices for clinical use with hypothermia or normothermia are already available for most organs. Whether and which perfusion strategy is superior to the others is the subject of current clinical research. This also applies to the further evaluation of possible synergistic effects in the sequential use of the various protocols. The common goal of all dynamic perfusion technologies is to optimize organ preservation between removal and transplantation. By testing the quality of marginal donor organs prior to transplantation, it should also be possible to use these organs without exposing the patient to increased risk. This can lead to a significant expansion of the donor pool. This is particularly important in Germany, where there is an ongoing shortage of organs and restrictive legislation regarding the expansion of the donor pool. Furthermore, the perfusion technology offers the possibility to serve as a platform for other ex situ and in situ therapies on isolated organs. In addition to the conditioning of pre-damaged organs for transplantation, this could lead to further applications in the context of targeted organ therapies and also to improved transplant logistics in the future.
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http://dx.doi.org/10.1007/s00104-024-02122-w | DOI Listing |
iScience
January 2025
Department of Radiology, The Affiliated Hospital of Southwest Medical University, 25# Tai Ping Street, Luzhou, Sichuan 646000, China.
Myocardial microcirculation in athletes and its relationship with cardiac remodeling (CR) and myocardial fibrosis (MF) are not fully understood. We prospectively enrolled 174 athletes and 54 healthy sedentary controls for intravoxel incoherent motion (IVIM) diffusion-weighted imaging of cardiac magnetic resonance imaging. Athletes exhibited significantly lower fast apparent diffusion coefficient (ADC) and perfusion fraction (f) in 16 myocardial segments and each blood supply area compared to controls ( < 0.
View Article and Find Full Text PDFAnn Surg
January 2025
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck.
Objective: To report outcomes from routine clinical practice of liver transplantation (LT) following normothermic liver machine perfusion (NLMP) and compare to LT after static cold storage (SCS).
Background: NLMP is emerging as a clinical routine in LT as has recently received renewed attention, however outcomes outside of clinical trials are lacking.
Methods: All adult LT between February 2018 and January 2023 were included.
J Intern Med
January 2025
Division of Transplantation Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
In recent years, there has been resurgence in donation after circulatory death (DCD). Despite that, the number of organs transplanted from these donors remains low due to concerns about their function and a lack of an objective assessment at the time of donation. This overview examines the current DCD practices and the classification modifications to accommodate regional perspectives.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
February 2025
Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure.
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