Preservation of Organs to Be Transplanted: An Essential Step in the Transplant Process

Maryne Lepoittevin (1, 2) , Sébastien Giraud (3, 2) , Thomas Kerforne (2, 3) , Benoit Barrou (4, 2) , Lionel Badet (5, 2, 6) , Petru Bucur (7) , Ephrem Salamé (8) , Claire Goumard (9, 4) , Eric Savier (4, 9) , Julien Branchereau (10, 11, 12, 13, 14) , Pascal Battistella (15, 16) , Olaf Mercier (17, 18) , Sacha Mussot (19, 20, 18, 17) , Thierry Hauet (2) , Raphael Thuillier (2, 3, 21)

1 Université de Poitiers - Faculté de Médecine et de Pharmacie
2 IRMETIST [Poitiers] - Ischémie reperfusion, métabolisme et inflammation stérile en transplantation [U 1313]
3 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
4 CHU Pitié-Salpêtrière [AP-HP]
5 Hôpital Edouard Herriot [CHU - HCL]
6 UCBL - Université Claude Bernard Lyon 1
7 CHU Trousseau [Tours]
8 Hôpital Trousseau
9 CRSA - Centre de Recherche Saint-Antoine
10 ITERT - Institut de Transplantation et de Recherche en Transplantation [CHU Nantes]
11 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
12 Service d'Urologie [Nantes]
13 NDS2 - Nuffield Department of Surgical Science [Oxford, UK]
14 Institute of Transplantation Urology and Nephrology [CHU Nantes]
15 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
16 UM - Université de Montpellier
17 Hôpital Marie-Lannelongue
18 HPPIT - Hypertension pulmonaire : physiopathologie et innovation thérapeutique
19 Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
20 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson,
21 FHU SUPORT - Fédération Hospitalo-Universitaire « SUrvival oPtimization in ORgan Transplantation »

Organ transplantation remains the treatment of last resort in case of failure of a vital organ (lung, liver, heart, intestine) or non-vital organ (essentially the kidney and pancreas) for which supplementary treatments exist. It remains the best alternative both in terms of quality-of-life and life expectancy for patients and of public health expenditure. Unfortunately, organ shortage remains a widespread issue, as on average only about 25% of patients waiting for an organ are transplanted each year. This situation has led to the consideration of recent donor populations (deceased by brain death with extended criteria or deceased after circulatory arrest). These organs are sensitive to the conditions of conservation during the ischemia phase, which have an impact on the graft’s short- and long-term fate. This evolution necessitates a more adapted management of organ donation and the optimization of preservation conditions. In this general review, the different aspects of preservation will be considered. Initially done by hypothermia with the help of specific solutions, preservation is evolving with oxygenated perfusion, in hypothermia or normothermia, aiming at maintaining tissue metabolism. Preservation time is also becoming a unique evaluation window to predict organ quality, allowing repair and/or optimization of recipient choice.

Keywords: kidney transplantation; organ preservation; oxygen; temperature

Domains: Life Sciences [q-bio]

Maryne Lepoittevin, Sébastien Giraud, Thomas Kerforne, Benoit Barrou, Lionel Badet, et al.. Preservation of Organs to Be Transplanted: An Essential Step in the Transplant Process. International Journal of Molecular Sciences, 2022, 23 (9), pp.4989. ⟨10.3390/ijms23094989⟩. ⟨hal-04522310⟩