Organsaving

Organsaving refers to the set of clinical practices, technologies, and systems designed to preserve and optimize donor organs from retrieval to transplantation. The aim is to maintain organ viability, reduce ischemic injury, and extend the usable window for transplantation. Organsaving encompasses a range of approaches, including the use of specialized preservation solutions, cooling strategies, and advanced perfusion techniques that can revive and stabilize organs before implantation. It also includes efforts to broaden the donor pool by enabling safer use of marginal donors.

Core methods include static cold storage, where organs are flushed with cold preservation solution and kept at low temperatures; hypothermic machine perfusion, which circulates preservative solution through the organ at cold temperatures; and normothermic machine perfusion, which maintains near-physiological temperature with oxygenated perfusate to support metabolism and permit functional assessment. In some contexts, normothermic regional perfusion is used to restore circulation in a donor prior to retrieval.

Organsaving techniques are applied to multiple organ types. Kidney preservation benefits from machine perfusion reducing delayed graft function and enabling use of extended criteria donors. Liver perfusion can improve preservation time and allow functional evaluation of marginal livers. Heart and lung perfusion enable longer transport and better assessment of suitability. Pancreas and composite tissues also benefit from targeted perfusion strategies.

The field supports higher transplant rates and better post-transplant outcomes but faces challenges including cost, equipment requirements, infrastructure, and the need for standardized protocols. Ethical considerations include donor consent, equitable organ allocation, and patient safety. Ongoing research aims to refine perfusion parameters, expand indications, and integrate organ-saving workflows into broader transplantation systems.