Organ Preservation For Transplantation

During the past 10 years, there have been many international meetings on the storage of organs prior to transplantation, and several have led to the publication of proceedings; there have also been a number of other books on this subject-. Most of these publications have concentrated on practical clinical aspects of organ preservation and on empirical animal experiments directed towards well-defined clinical objectives. Progress was rapid at first, but it is now generally agreed that there has been little improvement in techniques during the past 5 years, although understanding has certainly increased. In 1980 the Tissue Preservation and Banking Committee of the Transplantation Society decided that a fresh approach to the problem of improving preservation methods was needed: it was decided to hold a conference at which an opportunity would be provided to return to basic principles and to examine some of the advances that have occurred in recent yelns in areas of physiology that might be important for further improvements in preservation. The conference was held in Cambridge, UK, in April 1981 and this book is based upon the papers presented to that meeting and the work of a small discussion group that met after the main meeting. The book starts with six basic review chapters, followed by sections on the effects of ischaemia and anoxia, and on biochemical and pharmacological aspects of hypothermia. Chapters dealing with organ preservation by initial perfusion followed by hypothermia, and by continuous hypothermic perfusion, follow.

Discusses issues involved with organ procurement and preservation for transplantation including donor procurement criteria, perfusion and storage techniques, cryopreservation, ischemia/reperfusion injury and metabolic regulation. This book covers the kidney, liver, pancreas, small bowel, heart and lung, and informs the reader about preservation and procurement developments in the field of transplantation.

This new book, edited by internationally renowned specialists, also pools the experience of consultants from both Europe and the US. It is divided into three main sections: Organ Preservation, Organ Harvesting and Surgical Techniques. Many different organs are profiled, including the heart, kidneys, lungs, pancreas, intestine and bowel. The various aspects of preservation are discussed including cooling and preservation solutions, which are of special interest as researchers are actively exploring the composition of those solutions. Longer term preservation of the heart is still an unsolved problem and this is considered, as well as the pros and cons of organ donation from live or cadaveric donors. Fully referenced and illustrated with over 50 line drawings, Organ Preservation and Transplant Surgery will be of particular interest to those involved in the often complex surgery of organ harvesting or trainees in transplantation surgery. It gives clear accounts of techniques and a detailed update in the underlying science that determines and currently limits organ storage. It will also prove invaluable to the younger researcher who needs a clearer understanding of the scientific basis of organ preservation and the clinical need for better organ preservation.

The first edition of this book, Basic Concepts in Organ Procurement, Perfusion and Preservation for Transplantation, was published 27 years ago, in 1982 when organ procurement and preservation began to advance in the study of the best ways to preserve organs for transplantation. The second edition, Organ Procurement and Preservation for Transplanta

In the past few years the transplantation of organs in man has received publicity unprecedented in medical history. The first heart grafts were covered by press, radio, and television on a scal~ equiva lent to the news of the outbreak of a major war. Unwarranted and extravagant optimism has been followed by bitter criticism. This has undermined public confidence in the medical profession and seriously impeded progress in an important endeavour aimed at reducing human suffering. This unfortunate situation has arisen from widespread ignorance amongst the public and the medical profession of the background, present achievements, and future potential of organ grafting. Short statements by experts, frequently misquoted or cut short by television interviewers, and misinformed derogatory pronouncements by prejudiced medically qualified men, with no knowledge of the field, have produced a sorry state of confusion. It is the purpose of this book to attempt to clarify organ transplantation. The principles of organ transplantation are common to all organs but I will confine most of the discussion to transplantation of four vital organs, namely the kidney, liver, heart, and lung. ROY CALNE Cambridge January 1970 CONTENTS Preface IX List of Illustrations Xlll Acknowledgements XVll I. THE IDEA I II. THE SURGERY 7 III. REJECTION 15 IV. PREVENTION OF REJECTION 23 v. TISSUEMATCHING 39 VI. ORGAN PRESERVATION 47 VII. SUITABLE DONORS 53 VIII. ORGAN TRANSPLANTS 57 IX. ETHICS AND THE LAW 81 X.

The first edition of this book, Basic Concepts in Organ Procurement, Perfusion and Preservation for Transplantation, was published 27 years ago, in 1982 when organ procurement and preservation began to advance in the study of the best ways to preserve organs for transplantation. The second edition, Organ Procurement and Preservation for Transplantation, 2nd Edition, followed 15 years later, in 1997, with the goal of finding common denominators in the best preservation techniques for transplantation. In this current third edition, 11 years after the second edition, similar goals are still pursued of defining the best preservation methods, but there is now more evidence, including results, and new advances have reached publication and are being incorporated into ischemia and reperfusion techniques and organ preservation studies. Many preservation solutions have been introduced, important preservation solution components have been better defined, and improved perfusion methods are being considered, especially for the increasing number of organ donors with non-beating hearts who are being sought for transplantation. This edition (2009) engaged experts in the field of organ preservation to review, update, and rewrite each of the chapters. Crafted in collaboration with Luis H. Toledo-Pereyra, the text is eminently informative and easily understandable. Each solid organ that can be transplanted has an entire chapter devoted to the particular methods of its preservation. One chapter apiece, in other words, features insights on the preservation of the kidney, the liver, the pancreas, the small bowel, the heart, and the heart-lung. The title of the present book has been shortened to better represent its content. Thus, Organ Preservation for Transplantation, 3rd Edition, demonstrates a more accurate depiction of its current status. Nevertheless, the goal of this book remains exactly the same as in the first edition, that is “to analyze the most important aspects of organ procurement, perfusion and preservation for transplantation”.