Preservation of Organs for Transplant - Research Paper Example

The organ preservation techniques have improved and various organ preservation remedies are available and are in constant modification to provide enhanced tissues results and storage. The paper will analyze various methods involved in organ preservation and the possible outcomes. Introduction Organ preservation is the supply line for organ transplantation; preservations of organs for transplant are crucial to ensure effective tissue and organ function while in store to ensure reperfusion function. Some of the organs preserved for transplant include; Liver, kidney, heart and lungs. Discussion Following the successful testing of the immunosuppressive impacts of cyclosporine in transplant patients in 1970s, the field of organ transplants began a vertical growthand the field of organ preservation became increasingly important as the need to increase preservation time and improve graft functionbecame importantbecause of increased death cases due to lack of a transplant, (Toledo-Pereyra 25). To solve this donor crisis, there is a need to increase the donor pool leading to employment of different methods of organ preservation as discussed below. Static preservation method This involves use of Simple cold storageowing to the fact that hypothermia was employed for organ preservation to reduce the kinetics of metabolic activities that would otherwise lead to cellular death when oxygen is removed from the donor organ. In the storageprocess, the preservation remedy is infused into the tissues and the tissues are laterstatistically stored at reduced temperatures. The finding of the Collins' solution in 1969 increased SCS preservation time to 24 hr for kidneys owing to the fact that this solution reversed the sodium potassium concentration to mimic intracellular-like composition and also the high concentration of glucose molecules that reduce cell swelling. At this point, it is worth noting, maintenance of cellular energy must be accomplished and this is done through minimizing metabolic demand and ATP hypothermic hydrolysis. With the fall of tissue temperatures, the metabolic function reduces according to the Arrhenius equation, and when cells cool, the utilization of ATP utilization drops, because of sodium pump function. Sodiumpump regulates and reduces intracellular sodium under normothermic conditions, however, when the pump speed falls during hypothermia, the intracellular sodium rises, thus pulling water into the cell leading to lethal cell swelling (Toledo-Pereyra, 42). Methods With the modern technologies, some organs such as the liver can be stored for a longer periodthrough flushing the tissues or applying organ preservation fluids and preserving the tissues at (0–5° C) hypothermic temperatures. This method is efficient as it uses various impairmentagents such as lactobionic acid, raffinose, hydroxyethyl glucose that prevent swelling of the cells during storage, and because the solution contains glutathione and adenosine agents that trigger normal metabolism function upon reperfusion by triggering generation high-energy phosphate (adenosine) upon reperfusion. Since the development of the UW solution, other preservation solutions have been discovered, which include Histidine-Tryptophane-Ketoglutarate (HTK) and Celsior. However, some Percentages of organs such as livers, kidneys and intrathoracic organs fail upon transplant hence need for improved methods for preservation.Bottom of Form Dynamic preservation methods require some dynamic fluid or gas movement to allow preservation. In the 20th century, Hypothermic machine perfusion was invented for organ preservation to extend both preservation time and quality. Alexis Carrel coined the term organ culture referring to an analogous technique for whole organs that would be developed by using vascular perfusion with support of Charles Lindbergh who helped with the engineering in which he developed a glass perfusion pump that could support kidneys by maintaining oxygen delivery through perfusion. Hypothermic machine perfusion allows organs oxidation for ATP creation through fluid perfusion for oxygen transportation. The cold tissues oxygen requirements are low thus the oxygen demand is also low and this allows for slow flow rates during hypothermia and the relatively low oxygen carrying capacity of most crystalloid perforates are adequate at low temperatures. Belzer and Southard worked at perfecting HMP preservation of kidneys in the 70s and 80s, mainly by overcoming the side effects to hypothermia and perfusion on kidney function, (Toledo-Pereyra 56). They solved the problem of serum precipitation during perfusion by use of plasma lipoproteins hence a major advancement in hypothermic perfusion preservation of kidneysresulting to successful preservation of kidneys for 24to 72 hours. Another machine for perfusion preservation method is referred to as Normothermic (NMP). In 2001, Friend et el argued that normothermic machine had improved 24 hr preservation compared to SCS. The main advantage for NMP is fact that viability assessment is possible before implantation hence reducing incidenceof non-function of the graft, (Glassman, and Joel 21). Oxygen Persufflation method is an organ preservation technology developed by Isselhard et al and it utilizes oxygen that is bubbled through the vasculature and the escapes through small pins in the organ's surface. The method was first tested on canine kidney and proved to be effective in the liver with world homogenous supply of the gaseous oxygen, and has shown excellent results in recovering DCD organs. Results In many years following the first successful transplantation of organs, preservation of tissues and organs has attained incredible successes in enhancing and improving preservation and function of organs, and irrespective of these improvements, a huge disparity still exists among the number of people on the waiting list and the available organs donors. The main organ preservation challenge will be how to enhance the marginal donor organs recovery and resuscitation mainly the donation after cardiac organ death; therefore, given the success of static organ preservation methods, the dynamic preservation methods, oxygen persufflation methods and other methods, there is a crucial advances in improving the donor problems. Conclusion In conclusion, the preservation methods discussed are found to express multiple limitations thus studies encouraged to come up with more effective preservation methods. Works cited Glassman, Armand B, and Joel Umlas. Cryopreservation of Tissue and Solid Organs for Transplantation. Arlington, VA: AABB, 2003. Print. Toledo-Pereyra, Luis H. Organ Preservation for Transplantation. Austin, Tex: Landes Bioscience, 2010. Internet resource. Toledo-Pereyra, Luis H. Basic Concepts of Organ Procurement, Perfusion, and Preservation for Transplantation. New York: Academic Press, 2002. Print. Read More