Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 11, Issue 4, Pages 537-555Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656560903547836
Keywords
cold-ischemia-reperfusion injury; endothelins; melatonin; polyethylene glycol; preservation solution; trimetazidine; trophic factor; UW
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Funding
- Ministerio de Sanidad y Consumo, Madrid [PI081988]
- CIBER-ehd, Madrid
- Instituto Carlos III, Madrid
- Ministerio de Asuntos Exteriores y de Cooperacion Internacionales , Madrid [A/020255/08, A/029087/09]
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Areas covered in this review: The complex physiopathology of cold-ischemia-reperfusion (I/R) injury - and in particular cell death, mitochondrial injury and endoplasmic reticulum stress - are reviewed. Basic principles of the formulation of the different preservation solutions are discussed. What the reader will gain: Current strategies and new trends in static organ preservation using additives such as trimetazidine, polyethylene glycols, melatonin, trophic factors and endothelin antagonists in solution are presented and discussed. The benefits and mechanisms responsible for enhancing organ protection against I/R injury are also discussed. Graft preservation was substantially improved when additives were added to the preservation solutions. Take home message: Enrichment of preservation solutions by additives is clinically useful only for short periods. For longer periods of cold ischemia, the use of such additives becomes insufficient because graft function deteriorates as a result of ischemia. In such conditions, the preservation strategy should be changed by the use of machine perfusion in normothermic conditions.
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