BACKGROUNDOrgan preservation keeps the quality of the organs under prolonged ischemia. Continuous machine perfusions are gaining an important position in clinical research and practice. The aim of this study was to evaluate the protective effect of continuous hypothermic machine perfusion transport system (AirdriveTM) on cold ischemic injury of canine kidney.

METHODSTen kidneys of five healthy preserving canines were taken out after general anesthesia. Five kidneys were stored using common cold preservation (CCP group) by immersing it in the organ preservation solution, mixed with water and ice, and kept in a cold room at 4°C. The other five kidneys were stored using continuous machine perfusion preservation (CMP group) and were placed into the Airdrive(TM) continuous machine perfusion device at room temperature. The renal tissues were examined by histopathology, electron microscopy, and mitochondrial activity check at different time points.

RESULTSHistologic sections showed that the structures of the ten renal tissues were similar during the first 24 hours. After 48 hours, the CCP group showed more pronounced changes, as the renal tubular epithelial cells were more obvious than those in the glomeruli. Oxygen consumption rate of state III and IV respiration in the CCP group decreased after 12-48 hours and increased at 48 hours, respectively, when compared to the CMP group (P < 0.05). Cortex respiratory control ratio and phosphorus oxygen ratio were significantly higher in the CMP group at 48 hours.

CONCLUSIONWith prolonged storage time, the effect of continuous hypothermic machine perfusion transport system is better than that of common cold preservation on canine kidney.

Animals ; Dogs ; Kidney ; Kidney Transplantation ; Male ; Organ Preservation ; methods ; Organ Preservation Solutions

OBJECTIVETo summarize the experience of donor liver procurement and preparation in liver transplantation.

METHODSOne hundred and twenty-six cases of donor liver and kidney procurement and 105 cases of donor liver preparation from August, 2004 to December, 2006 were analyzed. The 105 donor liver grafts were all used for orthotopic liver transplantation.

RESULTSThe warm ischemia time of the graft ranged from 1 to 8.5 min with a mean of 4 min. The time of graft procurement ranged from 19 to 28 min (mean 22.5 min). Donor liver preparation lasted for 38 to 102 min in the 105 cases, with a mean of 51 min. The cold ischemia time of the donor liver was 5.5 to 13 h (mean 8 h). Anatomical variations were identified in 8 of the donor liver grafts.

CONCLUSIONSCold perfusion of the donor liver and repair of the hepatic artery are important procedures in donor liver procurement and preparation. Hemorrhage due to the donor graft should be prevented and the procedures should be performed in close cooperation with the recipient operation.

Adult ; Female ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Organ Preservation ; methods ; Tissue Donors ; Tissue and Organ Procurement ; methods ; Young Adult

Humans ; Liver Transplantation ; methods ; trends ; Living Donors ; Postoperative Complications ; Tissue and Organ Harvesting ; methods ; trends

The quality of a donor liver after cardiac death is closely associated with energy metabolism during preservation. Ex vivo mechanical perfusion has broad application prospects because this technique can help energy metabolism and repair ischemia injury of donors' livers. Some core issues are presented in this review in order to provide references for propelling secure application of liver transplantation based on donation after cardiac death.
Death ; Humans ; Liver ; Liver Transplantation ; Organ Preservation ; methods ; Perfusion ; methods ; Warm Ischemia ; adverse effects

Humans ; Liver ; blood supply ; Liver Transplantation ; methods ; Living Donors ; Survival Analysis ; Tissue and Organ Harvesting ; methods

OBJECTIVETo investigate operative techniques, treatment and precaution of common complications of orthotopic intestinal transplantation in the rats.

METHODSOrthotopic intestinal transplantation was performed in 120 rats by modified three cuffs method. The causes, treatment and precaution of common complications were analyzed retrospectively.

RESULTSThe 7-day survival rate of recipients was 82.5% and the 30-day survival rate was 68.3%. The average volume of bleeding in the recipient operation was less than 1 ml. The result obtained from the above 99 recipients was satisfactory. The main reasons of final failure and death were as follows: anastomotic bleeding(5 rats), portal vein thrombus(2 rats), arterial thrombus(4 rats), air embolism(1 rat), infection of abdominal cavity(4 rats), aspiration pneumonitis (2 rats), anesthetic accident(2 rats) and kinking of graft intestine(1 rat).

CONCLUSIONSThe sophisticated surgical technique and the delicate surgical manipulation are the prerequisite of preventing operational complication. Improving operative techniques and being familiar with the common complications can reduce the occurrence of complications and increase operative successful rate.

Animals ; Intestines ; transplantation ; Male ; Organ Transplantation ; adverse effects ; methods ; Postoperative Complications ; Rats ; Rats, Sprague-Dawley ; Transplantation, Homologous

Intestinal transplantation has been established as a treatment option for patients that suffer from intestinal failure with complications from total parenteral nutrition. It is still rapidly evolving and just reached a landmark of 1, 000 cases worldwide. Intestinal allografts can be transplanted as isolated, combined with the liver or as a part of a multivisceral allograft. Tacrolimus-based immunosuppression regimens have been used universally with improved outcomes. Clinical outcome in intestinal transplantation has improved significantly over time, impacted by refinement of surgical technique and novel immunosuppression. However rejection, infection, and technical complications still remain the most difficult barrier to improve patient and graft survival.
Acute Disease ; Graft Rejection/diagnosis ; Humans ; Immunosuppression ; Intestines/*transplantation ; Nutritional Support ; Organ Transplantation/methods ; Postoperative Care ; Viscera/*transplantation

OBJECTIVETo explore the operational strategy of harvesting total facial allograft by autopsy.

METHODSTwelve fresh human cadavers were dissected. They were divided into two groups randomly. The total facial-scalp flap of the group I was elevated by the bi-pedicle method, the group II was operated with single-pedicle method. Both were dissected at the deep plane of the SMAS. : the time of facial flap harvesting, length of the artery vein and nerve pedicles of the donor were measured and marked, after operation, in each group we transferred one facial allograft to another. Then the free graft of group I was poured through artery by methylthioninium chloride to study vascular territories.

RESULTSMean harvesting time of the group I (46 +/- 11) minutes, group II (111 +/- 7) minutes, P < 0.01. Perfusion result shows that unilateral superficial temporal artery and the opposite side of the facial artery can supply blood for whole face. The pedicle was long enough for anastomosis. Post-operation appearance: the face looks like neither the donor nor the recipient primarily, It's mainly due to the characteristics of the skeleton and the soft tissues.

CONCLUSIONSThe bi-pedicle method of the harvesting total facial allograft is concise, fast, safe can be widely applied in clinical.

Aged ; Face ; surgery ; Facial Transplantation ; methods ; Female ; Humans ; Male ; Skin Transplantation ; Surgical Flaps ; Tissue Donors ; Tissue and Organ Harvesting ; methods ; Transplantation, Homologous ; methods ; Transplants

OBJECTIVETo review the role of heme oxyenase-1 in organ transplantation and explore the potential applications targeted on overexpression of heme oxyenase-1 gene.

DATA SOURCESThe data cited in this review were mainly obtained from the articles listed in Medline and PubMed, published from January 1996 to December 2008. The search terms were "heme oxygenase-1" and "transplantation".

STUDY SELECTIONArticles regarding the role of heme oxyenase-1 in organ transplantation and its protective role in transplants were selected. Protective effects of heme oxygenase-1 overexpression using a gene transfer approach against ischaemic reperfusion injury during transplantation were widely explored.

RESULTSLocal heme oxygenase-1 overexpression in the graft ameliorates the ischaemic reperfusion injury. This is due to removal of heme, a potent prooxidant and proinflammatory agent, but also because of generation of biologically active products.

CONCLUSIONSOverexpressive heme oxygenase-1 activity is associated with tissue protection in the setting of graft, ischaemic reperfusion injury. Gene therapy is attractive to us; but a long way from general application. In terms of heme oxygenase-1, the gene promoters are polymorphic. Although individualization is an important principle during clinical application, it is difficult to put into practice.

Animals ; Heme Oxygenase-1 ; genetics ; metabolism ; Humans ; Organ Transplantation ; methods ; Reperfusion Injury ; therapy

Anastomosis, Surgical ; methods ; Humans ; Organ Transplantation ; adverse effects ; methods ; Postoperative Complications ; etiology ; surgery ; Vascular Surgical Procedures ; methods