title: Advances in organ preservation for transplantation.
abstract: Organ transplantation provides the best available therapy for a myriad of medical conditions, including end-stage renal disease, hepatic failure and type I diabetes mellitus. The current clinical reality is, however, that there is a significant shortage of organs available for transplantation with respect to the number of patients on organ waiting lists. As such, methods to increase organ supply have been instituted, including improved donor management, organ procurement and preservation strategies, living organ donation, transplantation education and the increased utilization of donation after circulatory death and expanded criteria donors. In particular, especially over the last decade, we have witnessed a significant change in the way donor organs are preserved, away from static cold storage methods to more dynamic techniques centred on machine perfusion (MP). This review highlights the current state and future of organ preservation for transplantation, focusing on both abdominal and thoracic organs. In particular, we focus on MP preservation of renal, hepatic, pancreatic, cardiac and lung allografts, also noting relevant advances in Australasia. MP of organs after procurement holds considerable promise, and has the potential to significantly improve graft viability and function post-transplantation, especially in donors in whom acceptance criteria have been expanded.
authors.affiliation: Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.|Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ahmer M
authors.initials: AM
authors.lastname: Hameed
authors.affiliation: Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.|Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Hawthorne
authors.affiliation: Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.|Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Pleass
mesh_terms: D044362:Australasia / Q000453:epidemiology; D001926:Brain Death / Q000145:classification*; D015925:Cryopreservation / Q000379:methods; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000295:instrumentation* / Q000379:methods; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000706:statistics & numerical data; D014850:Waiting Lists
keywords: 
  DCD
  ; 
  ECD
  ; cold storage; machine perfusion; organ preservation