Organ retrieval and preservation

Abstract

The success of organ transplantation can be attributed to many factors but ultimately depends upon retrieval and preservation techniques to maintain the quality of an organ. Thoracic and abdominal organs from deceased donors are retrieved during a multi-organ procedure. The organs are flushed and cooled in-situ with preservation solution followed by dissection and removal. With the high-risk donors such as donation after cardiac death, rapid in-situ cooling is essential to minimize the injury. Live kidney donation is becoming increasingly popular and the disincentives have been significantly reduced by the introduction of minimally invasive techniques such as the laparoscopic retrieval technique. Segments of the liver, pancreas, lung and small bowel are also being used for live donation. Organ preservation relies on hypothermic temperatures to reduce the metabolism and requirement for oxygen. Storing the organ on ice is the most practised method of preservation (static cold storage), although other methods such as hypothermic machine perfusion are becoming popular for kidney preservation. Preservation solutions are designed to maintain cell membrane stability, prevent intracellular acidosis and cellular swelling. Various solutions are available however, the University of Wisconsin (UW) solution remains the gold standard for all organs. This review focuses on retrieval and preservation techniques in solid organ transplantation.