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Review
. 2020 Feb 27:11:192.
doi: 10.3389/fimmu.2020.00192. eCollection 2020.

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

Mindaugas Kvietkauskas  1   2 , Bettina Leber  1 , Kestutis Strupas  2 , Philipp Stiegler  1 , Peter Schemmer  1
Affiliations
Review

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

Mindaugas Kvietkauskas et al. Front Immunol. .

Abstract

Due to higher vulnerability and immunogenicity of extended criteria donor (ECD) organs used for organ transplantation (Tx), the discovery of new treatment strategies, involving tissue allorecognition pathways, is important. The implementation of machine perfusion (MP) led to improved estimation of the organ quality and introduced the possibility to achieve graft reconditioning prior to Tx. A significant number of experimental and clinical trials demonstrated increasing support for MP as a promising method of ECD organ preservation compared to classical static cold storage. MP reduced ischemia-reperfusion injury resulting in the protection from inadequate activation of innate immunity. However, there are no general agreements on MP protocols, and clinical application is limited. The objective of this comprehensive review is to summarize literature on immunological effects of MP of ECD organs based on experimental studies and clinical trials.

Keywords: extended criteria donors; immunological rejection; machine perfusion; marginal organs; transplantation.

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Figures

Figure 1
Figure 1
T cell allorecognition pathways in organ transplantation. APC, antigen-presenting cell; HLA, human leukocyte antigen.
Figure 2
Figure 2
Different machine perfusion strategies of extended criteria donor organs for protection against activation of innate immunity.
See this image and copyright information in PMC

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