Organ preservation: from the past to the future.

Organ transplantation is the most effective therapy for patients with end-stage disease. Preservation solutions and techniques are crucial for donor organ quality, which is directly related to morbidity and survival after transplantation. Currently, static cold storage (SCS) is the standard method for organ preservation. However, preservation time with SCS is limited as prolonged cold storage increases the risk of early graft dysfunction that contributes to chronic complications. Furthermore, the growing demand for the use of marginal donor organs requires methods for organ assessment and repair. Machine perfusion has resurfaced and dominates current research on organ preservation. It is credited to its dynamic nature and physiological-like environment. The development of more sophisticated machine perfusion techniques and better perfusates may lead to organ repair/reconditioning. This review describes the history of organ preservation, summarizes the progresses that has been made to date, and discusses future directions for organ preservation.

Formalin use in anatomical and histological science in the 19th and 20th centuries.

The introduction of formalin, a formaldehyde solution, as a disinfectant and fixative was an essential improvement in anatomical and histological science. This paper is an outline of the historical use of formalin based on primary source texts and historical studies. We describe how the discovery of acetaldehyde in the 18th century led to the development of formalin as the most common ingredient in embalming fluids in the 20th century and is still used today. Particularly important contributions to this process were made by Justus von Liebig, Alexander Butlerow and August Wilhelm Hofmann in the development of anatomical and histological preparation techniques, and by Ferdinand Blum, Ferdinand Julius Cohn, Frederick C. Kenyon and Victor Wehr in the practical uses of formaldehyde solutions in preservation and fixation of soft tissues. However, formalin is not without its drawbacks and as its toxicity became more understood, method to mitigate its effects were demanded. Eventually safer preparation techniques were developed, including Hagens' plastination and Thiel Embalming Method. These techniques may someday largely replace high-concentration formalin solutions but they both still require at least small quantities of formaldehyde to preserve tissues for study.

[Serendipity, beneficial error, and chance in the development of kidney transplantation]. / Le hasard, l'erreur profitable, la chance dans le développement de la transplantation renale.

Serendipity played an essential role in two major developments of organ transplantation: the method of continuous hypothermic perfusion of the kidney and the introduction of ciclosporin in the clinical setting. An erroneous reasoning lead to the creation of an efficient preservation fluid: Collins's solution. However, these investigations would have failed without the open-mindedness and the tenacity of the clinicians.

Cold ischemic injury of transplanted kidneys: new insights from experimental studies.

Kidney transplantation is the preferred and definitive treatment for end-stage renal disease (ESRD), and kidneys from deceased donors are a major source for it. These kidneys are routinely cold stored to prolong viability, which, however, when prolonged can cause injury, resulting in reduced graft function and survival. Recent experimental studies have identified the release of iron and free radicals, activation of calpain, and formation of F(2)-isoprostanes as important components of cold ischemic injury, as are the swelling of mitochondria and activation of mitochondrial apoptotic pathways. Moreover, studies have also suggested that fortifying the storage solution with deferoxamine or preconditioning the donor kidneys with hemeoxygenase-1 may prove viable clinical strategies to limit cold ischemic injury. This review will summarize these and other new experimental data that have implications for reducing cold ischemic transplant injury, a step necessary to improve deceased-donor allograft survival.