{"id":11152,"date":"2014-07-02T10:55:45","date_gmt":"2014-07-02T15:55:45","guid":{"rendered":"http:\/\/www.salud.carlosslim.org\/?p=11152"},"modified":"2014-07-17T11:41:24","modified_gmt":"2014-07-17T16:41:24","slug":"una-tecnica-prolonga-el-tiempo-de-conservacion-de-higados-para-su-trasplante","status":"publish","type":"post","link":"http:\/\/www.salud.carlosslim.org\/english2\/una-tecnica-prolonga-el-tiempo-de-conservacion-de-higados-para-su-trasplante\/","title":{"rendered":"A Technique Extends Liver Preservation Time for Transplantation"},"content":{"rendered":"<p><a href=\"http:\/\/www.salud.carlosslim.org\/wp-content\/uploads\/2014\/07\/3-Una-tecnica-prolonga-el-tiempo-de-conservacion-de-higados-para-su-trasplante.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-11154\" src=\"http:\/\/www.salud.carlosslim.org\/wp-content\/uploads\/2014\/07\/3-Una-tecnica-prolonga-el-tiempo-de-conservacion-de-higados-para-su-trasplante.jpg\" alt=\"3 Una tecnica prolonga el tiempo de conservacion de higados para su trasplante\" width=\"196\" height=\"130\" \/><\/a><\/p>\n<p>One of the greatest problems of <strong>organ transplantation<\/strong> lies in the short time that must elapse among the organ is available and it is <strong>transplanted<\/strong> in the receiver. Although it depends in many variables (the donor and type of organ), generally speaking, a kidney needs to be <strong>transplanted<\/strong> in 24 hours after it was available; although it may work after cold storage up to 48 hours. Heart and lungs can only be conserved around 6 hours, while liver and pancreas up to 12 hours. In any case it is always preferable to <strong>transplant<\/strong> as soon as possible.<\/p>\n<p>However now, according to a study published in <strong>\u201cNature Medicine\u201d,<\/strong> it may be possible to extend the organs life once they are removed from the donor thanks to an innovative supercooling system. In particular, researchers at the <strong>National Institutes of Health (NIH)<\/strong> in the US have successfully proved this new technique of <strong>supercooling<\/strong> in rats. If this is also fortunate for humans, it would remarkably increment the number of <strong>organs<\/strong> available to <strong>transplant, <\/strong>thus saving more lives.<\/p>\n<p>More than 60 years ago it was held the first <strong>transplant<\/strong> of a solid human organ, a kidney; this was a milestone that changed modern medicine. Since then, it has been transplanted all types of organs; such as hearts, lungs, corneas, among others. Furthermore, it has also been used for tissues, such as skin. Nevertheless, due to the shortage of donor organs, waiting lists continue to grow all over the world.<\/p>\n<p>With current techniques it is impossible to preserve a <strong>liver <\/strong>for no more than 24 hours; the methos combines low temperatures and a chemical solution developed by <strong>University of Wisconsin-Madison<\/strong> scientists in 1983. The solution helps keep alive the<strong> liver<\/strong> tissue during transit from the donor to the receiver. In this way, it has been possible to recover many organs, increasing the number of successful <strong>transplants.<\/strong> Although, this has not been enough; particularly in the case of the <strong>liver<\/strong>, which is the second organ more <strong>transplanted<\/strong> in Europe, after the kidney (112,631 solid organs were <strong>transplanted <\/strong>in the EU in 2012, from which 23,721 were <strong>livers<\/strong>)<\/p>\n<p>The possibility of extending the preservation time of a donated <strong>liver<\/strong>, explained the authors, would have numerous benefits: more time to prepare the patient and facilitate the hospital donor logistic; less urgency in the collection and transfer of the organ into its destination; an increase in the donor area that could increase intercontinental and transcontinental <strong>transplants<\/strong>; in addition, it would beneficiate the possibility of selecting the most appropriate organ for each patient.<\/p>\n<p>The biggest challenge for long-term preservation of human organs derives manly from severe tissue damage that occurs when organs are cryopreserved; in other words, frozen at temperatures of -320.8 degrees Fahrenheit. While this system is very effective in the conservation of simple cells or tissues, in the case of larger organs the multiple cell types and other structures react in different ways to cold. To solve this problem, the team of <strong>Martin Yarmush<\/strong> and <strong>KorKut Uygun<\/strong> \u2013researchers at <strong>Massachusetts General Hospital\u2019s Centre for Medical Engineering in Boston<\/strong>-, have develop a preservation technique that has tripled the amount of time a rat<strong> liver<\/strong> can be stored before being <strong>transplanted. <\/strong><\/p>\n<p>The process, as described in <strong>\u201cNature Medicine\u201d<\/strong>, consists in four steps. First, a machine perfusion is used; which is a technique to deliver oxygen and nutrients to the capillaries in the biological tissues, while remaining outside the body and being able of <strong>supercooling the hepatic tissue<\/strong> without irreversibly cell damaging. Second, to achieve this, the researchers added <strong>3-OMG (3-O-methyl-D-glucose)<\/strong>, a modified non-toxic glucose compound to the traditional solution. The <strong>3-OMG<\/strong>, they explained, cannot be metabolized by <strong>liver <\/strong>cells, thus it accumulates in them; working as a cold shield. Third, the team also modified the solution by adding <strong>35-kD (polyethylene glycol)<\/strong> to specifically protect cell membranes. <strong>Ethylene glycol<\/strong> is the active ingredient in anti-freeze, and it works by lowering the freezing point of a solution. Finally, the livers were then slowly cooled below the freezing point, to 21 degrees Fahrenheit, without inducing freezing, thereby <strong>supercooling <\/strong>the organ for preservation. After storing the organs for several days, the researchers again used machine perfusion to rewarm the organ, while also delivering oxygen and other nutrients to prepare the organ for <strong>transplantation.<\/strong><\/p>\n<p>Through this new technique, researchers were able to store <strong>supercooled<\/strong> rat livers during 3 days (72 hours) and 4 days (96 hours) at 21degrees Fahrenheit. All animals which received the livers stored for 3 days survived after three months and the survival rate of the rats receiving livers stored for four days were 58%; however, any of the animals that received livers with current method did.<\/p>\n<p>To understand which steps of this system were essential, researchers tested eliminating the <strong>PEG-35<\/strong> or <strong>3-OMG<\/strong>, in both cases the animals died after a week; while the animals that receive livers that were not implemented the machine perfusion or the <strong>supercooling <\/strong>died after an hour of the <strong>transplant.<\/strong><\/p>\n<p>This technique must now go through extensive testing and be refined before they can think in use it in humans, but the first results are very encouraging. &#8220;The longer we are able to store the <strong>donated organs<\/strong>, the greater the likelihood that the patient can find the best possible organ&#8221; the researchers conclude.<\/p>\n<p>&nbsp;<\/p>\n<p>Source: <a href=\"http:\/\/www.abc.es\/salud\/noticias\/20140629\/abci-organos-traplante-mayor-supervivencia-201406271808.html\" target=\"_blank\">www.abc.es<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the greatest problems of organ transplantation lies in the short time that must elapse among the organ is available and it is transplanted in the receiver. Although it depends in many variables (the donor and type of organ), generally speaking, a kidney needs to be transplanted in 24 hours after it was available; &#8230;<\/p>\n","protected":false},"author":1,"featured_media":11154,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[3],"tags":[13],"class_list":["post-11152","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualidad-en-la-salud","tag-renal","cat-3-id","has_thumb"],"_links":{"self":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/11152","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/comments?post=11152"}],"version-history":[{"count":3,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/11152\/revisions"}],"predecessor-version":[{"id":11449,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/11152\/revisions\/11449"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/media\/11154"}],"wp:attachment":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/media?parent=11152"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/categories?post=11152"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/tags?post=11152"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}