Early evaluation of graft viability using hepatic venous oxygen saturation in pig liver transplantation

Single cell electrophoresis in determining cell death: Potential for use in organ transplant research

Viability of donor tissues is essential for the success of organ transplantation. Although much work has been done in the field of organ preservation, currently there are few objective methods for evaluating transplant organ viability, and thus preservation efficiency. In the field of cancer biology, single-cell gel electrophoresis (SCGE) is a technique commonly used to measure the efficacy of anti-tumor treatments by measuring the breakdown of tumor cell deoxyribonucleic acid (DNA). This assay has recently been applied to various organs from a postmortem porcine animal model, and cells were found to undergo postmortem breakdown in a way similar to apoptosis-induced DNA fragmentation. Collections of cells from each organ reached levels indicative of non-viability as the postmortem interval (PMI) progressed. The rates of cellular DNA degradation were found to be specific to each organ type at a given ambient temperature. We believe that following the application of various preservation techniques, SCGE assay has the potential to provide a clear indication of cell viability in an organ destined for transplant. As a readily available viability assay, this technique could provide transplant researchers with a useful tool to quantify the efficacy of their experimental organ preservation techniques.

Liver and kidney preservation by perfusion

The clinical boundaries of transplantation have been set in an era of simple cold storage. Research in organ preservation has led to the development of flush solutions that buffer the harsh molecular conditions which develop during ischaemia, and provide stored organs that are fit to sustain life after transplantation. Although simple and efficient, this method might be reaching its limit with respect to the duration, preservation, and the quality of organs that can be preserved. In addition, flush preservation does not allow for adequate viability assessment. There is good evidence that preservation times will be extended by the provision of continuous cellular substrate. Stimulation of in-vivo conditions by ex-vivo perfusion could also mean that marginal organs will be salvaged for transplantation. Perfusion will also allow for assessing the viability of organs before transplantation in a continuous fashion. The cumulative effect of these benefits would include expansion of the donor pool, less risk of primary non-function, and extension of the safe preservation period. Use of non-heart-beating donors, international organ sharing, and precise calculation of the risk of primary organ failure could become standard.