The University of Wisconsin organ preservation solution: Components, comparisons, and modifications

Abstract

T he University of Wisconsin organ preservation solution (the UW Solution) is a complex one, developed over a 15-year span, with the intent of creating a versatile solution that could be used for preservation of all organs under cold storage or machine perfusion. It has improved preservation of the liver, 1-3 kidney, 4-6 pancreas, 7'8 intestine, 9 heart, 1°-14 and lung. 15,16 Improvements have been shown both for quality of functions as well as increased duration of preservation by cold static storage. Because of the UW Solution, longer preservation times are now being used to advantage. However, as a result, the incidences of primary nonfnnction and initial dysfunction of the liver and delayed graft function of the kidney are not much different from those before the development of the UW Solution. Studies have shown that the longer preservation periods lead to a greater incidence of complications after transplantation of the liver 17,18 and kidney. 5 Whereas many of these complications may be related to donor or recipient factors, most are likely caused by preservation/reperfusion injury. We must continue to identify and minimize these preservation injuries. To make those improvements requires greater knowledge of how solution components affect preservation. In the UW Solution, each component was carefully considered in light of what we knew at the time regarding the biochemistry of ischemic events and reperfusion injury of the transplantable organs. Now, parallel research efforts into the mechanisms of injury caused by hypothermic storage and reperfusion must be meshed with continuing research to improve on current preservation solutions. In this article we review studies that have re-