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Organ resuscitation 

Organ resuscitation
Chapter:
Organ resuscitation
Author(s):

Ernesto A. Pretto

, Kyota Fukazawa

, and Antonello Pileggi

DOI:
10.1093/med/9780199651429.003.0010
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date: 18 August 2019

Organ resuscitation refers to therapeutic interventions designed to prevent or mitigate graft injury during the three principal phases of organ transplantation: (1) donor: prevention of haemodynamic, hormonal, and metabolic derangements, with the institution of various means of inducing donor ‘preconditioning’; (2) ex-vivo preservation: methods and regimens to preserve cell function during ischaemia; and (3) recipient: mitigation of reperfusion injury and ‘postconditioning’. It is essential to prevent or reduce graft ischaemia–reperfusion injury during transplantation for two primary reasons: (1) to mitigate graft dysfunction early upon reperfusion; and (2) to reduce the risk of triggering innate immunity that shortens graft longevity and increases the likelihood of acute and chronic immune rejection episodes. This chapter reviews the pathophysiological phases and intracellular molecular mechanisms that lead to primary graft failure or delayed function. It also describes potential molecular targets for organ resuscitation.

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