title: Kidney preservation: review of present and future perspective.
abstract: One of the main problems in transplant surgery is the preservation of the organ during the cold ischemic time. The interrupted blood supply triggers a cascade of biological modifications resulting in cell death, which predisposes to discharge of a large quantity of toxic metabolites at the moment of organ reperfusion. Many approaches have been studied to prevent the toxic processes. Immediately after procurement, kidneys are flushed with these solutions. Two main: techniques of organ preservation are cold static storage and hypothermic machine perfusion (HMP). Based on age and comorbidities, individuals can be generally divided into 2 groups: ideal and marginal donors. Characteristics of organs from marginal donors are associated with an increased rate of delayed graft function and primary graft nonfunction (PNF), which reduce transplant survival and increase the acute rejection risk. In the last 20 years, the United Network of Organ Sharing has reported a 170% increase in deceased donors older than 50 years of age. Techniques of perfusion have been demonstrated to play a pivotal role in graft function after transplantation. Some studies suggest that HMP may improve outcomes after transplantation.
authors.affiliation: General and Trauma Surgery Department, Parma Hospital, Parma, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catena
authors.forename: F
authors.initials: F
authors.lastname: Coccolini
authors.forename: G
authors.initials: G
authors.lastname: Montori
authors.forename: C
authors.initials: C
authors.lastname: Vallicelli
authors.forename: A
authors.initials: A
authors.lastname: Amaduzzi
authors.forename: G
authors.initials: G
authors.lastname: Ercolani
authors.forename: M
authors.initials: M
authors.lastname: Ravaioli
authors.forename: M
authors.initials: M
authors.lastname: Del Gaudio
authors.forename: R
authors.initials: R
authors.lastname: Schiavina
authors.forename: E
authors.initials: E
authors.lastname: Brunocilla
authors.forename: G
authors.initials: G
authors.lastname: Liviano
authors.forename: G
authors.initials: G
authors.lastname: Feliciangeli
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D001926:Brain Death; D006801:Humans; D007668:Kidney; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D014019:Tissue Donors
chemical_list: D019188:Organ Preservation Solutions