Persufflation (or gaseous oxygen perfusion) as a method of organ preservation

Abstract

Improved preservation techniques have the potential to improve transplant outcomes by better maintaining donor organ quality and by making more organs available for allotransplantation. Persufflation, (PSF, gaseous oxygen perfusion) is potentially one such technique that has been studied for over a century in a variety of tissues, but has yet to gain wide acceptance for a number of reasons. A principal barrier is the perception that ex vivo PSF will cause in vivo embolization post-transplant. This review summarizes the extensive published work on heart, liver, kidney, small intestine and pancreas PSF, discusses the differences between anterograde and retrograde PSF and between PSF and other conventional methods of organ preservation (static cold storage, hypothermic machine perfusion). Prospective implications of PSF within the broader field of organ transplantation, and in the specific application with pancreatic islet isolation and transplant are also discussed. Finally, key issues that need to be addressed before PSF becomes a more widely utilized preservation strategy are summarized and discussed.

Retrograde Oxygen Persufflation of Kidney – Experiment on an Animal

“…14, 15). We did not find evidence to support the opinion of some authors that ROP may even be superior compared to standard perfusion or cold storage (16). On the other hand, we have proven beyond reasonable doubt that mere ROP is able to protect and restore parenchyma.…”

“…More recent similar experiments were performed on porcine animals (14,15). A recent article by Suszynski et al describes all preservation methods for different organs very well (16).…”

Hypothermic machine perfusion in liver transplantation

“…The delivery of oxygen under cold conditions to different types of tissues has been tested long before the development of hypothermic machine perfusion [42]. In this context, gaseous oxygen persufflation was beneficial against warm and cold ischemia in various organs and achieved better organ quality compared with cold storage [43].…”

Optimization of Cooling Protocols for Hearts Destined for Transplantation

“…This method has a higher risk of damage to the vascular structures due to perfusion pressures compared to the static cold preservation. In terms of technical complexity and cost, this method is moderately complicated and relatively inexpensive [14,15].…”

“…Cold preservation approaches can be classified into three major methods: static cold storage, hypothermic machine perfusion and persufflation [14]. In the static cold method, the organ is cooled only from outside by using a cooling solution.…”