title: Intestinal preservation for transplantation: current status and alternatives for the future.
abstract: OBJECTIVE
  Among transplantable abdominal organs the intestine has the shortest cold storage time, raising significant medical and logistical challenges. Herein, established and innovative, emerging concepts in intestinal preservation are summarized.
  
  
  RESULTS
  The method of intestinal preservation using an in-situ vascular perfusion followed by static storage remained unchanged for almost 30 years, despite suboptimal results. Advanced preservation injury occurs within 12 h and is little influenced by the type of solution used. Recent reports indicate that several customized luminal solutions containing various amino acids and macromolecules may delay its development. In addition, gaseous interventions in the storage solutions or in the lumen seem promising and easily applicable tools that may further reduce the ischemia-reperfusion injury and safely prolong the preservation time. Rodent models are not entirely suitable for direct translation to clinical practice as the development of preservation injury is faster than in humans.
  
  
  CONCLUSIONS
  The limitations of intestinal preservation originate in the methods (vascular perfusion and static storage) rather than in the solutions used. Several additional strategies promise to prolong the cold storage and reduce its impact on the intestinal graft and deserve further exploration in large animals and clinical studies.
authors.affiliation: aThe Transplant Institute, Sahlgrenska University Hospital bDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mihai
authors.initials: M
authors.lastname: Oltean
mesh_terms: D000818:Animals; D003080:Cold Temperature; D006085:Graft Survival; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions; D015427:Reperfusion Injury
chemical_list: D019188:Organ Preservation Solutions