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Review
. 2022 Mar 25:13:830992.
doi: 10.3389/fimmu.2022.830992. eCollection 2022.

Revisiting the Principles of Preservation in an Era of Pandemic Obesity

John T Langford  1 , Jenna R DiRito  1 , Natty Doilicho  2 , Graylen R Chickering  2 , David A Stern  1 , Xinshou Ouyang  3 , Wajahat Mehal  3 , Gregory T Tietjen  1   2
Affiliations
Review

Revisiting the Principles of Preservation in an Era of Pandemic Obesity

John T Langford et al. Front Immunol. .

Abstract

The current obesity epidemic has caused a significant decline in the health of our donor population. Organs from obese deceased donors are more prone to ischemia reperfusion injury resulting from organ preservation. As a consequence, these donors are more likely to be discarded under the assumption that nothing can be done to make them viable for transplant. Our current methods of organ preservation-which remain relatively unchanged over the last ~40 years-were originally adopted in the context of a much healthier donor population. But methods that are suitable for healthier deceased donors are likely not optimal for organs from obese donors. Naturally occurring models of acute obesity and fasting in hibernating mammals demonstrate that obesity and resilience to cold preservation-like conditions are not mutually exclusive. Moreover, recent advances in our understanding of the metabolic dysfunction that underlies obesity suggest that it may be possible to improve the resilience of organs from obese deceased donors. In this mini-review, we explore how we might adapt our current practice of organ preservation to better suit the current reality of our deceased donor population.

Keywords: cold storage; fasting; hibernation; metabolism; obesity.

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Conflict of interest statement

GT is the co-founder of Revalia Bio. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Trend showing the increasing rate of obese donors over time in both (A) brain death donors and (B) circulatory death donors.
Figure 2
Figure 2
Potential pathway to restore organs from obese donors.
See this image and copyright information in PMC

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