New concepts in organ preservation.
Organ preservation between donor and recipient is an important link in a chain that ultimately should lead to long term survival of the recipient thanks to a well-preserved, functionally intact organ. The period of organ ischaemia outside the body is subject to a number of biochemical stress factors which become known in more detail as knowledge on biochemical and immunological mechanisms improves. Efficacy of preservation fluids hence reduction of ischaemia injury may become enhanced by such additives as ion channel blockers, enzyme inhibitors, haeme oxygenase modulators, endothelin-l-inhibitors, quenchers of free radicals and anti-apoptotic agents. Many of these compounds, albeit of great theoretical interest, have not (yet?) made their way into clinical practice. This contribution is a survey of some promising agents, concentration and physicochemical interactions of which are analysed in some detail.
Clinic for Cardiovascular Surgery, University Hospital, Bern, Switzerland. urs.nydegger@insel.ch
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Nydegger
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T
Carrel
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T
Laumonier
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P
Mohacsi
D000111:Acetylcysteine / Q000494:pharmacology; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology; D005466:Fluorocarbons / Q000494:pharmacology; D006419:Heme Oxygenase (Decyclizing) / Q000502:physiology; D051547:Heme Oxygenase-1; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D008565:Membrane Proteins; D009926:Organ Preservation; D019188:Organ Preservation Solutions / Q000494:pharmacology; D013696:Temperature; D014292:Trimetazidine / Q000494:pharmacology
D002121:Calcium Channel Blockers; D005466:Fluorocarbons; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008565:Membrane Proteins; D019188:Organ Preservation Solutions; C496541:HMOX1 protein, human; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1; D014292:Trimetazidine; D000111:Acetylcysteine