Oxygenated machine perfusion of donor livers and limbs: Studies on endothelial activation and function

Donor organ viability is closely linked to transplant success. In an attempt to overcome the ongoing organ shortage, the criteria for organ donation are progressively being extended. These suboptimal grafts are, however, more prone to preservation and reperfusion related injury and are associated with in inferior transplant outcomes. Oxygenated machine perfusion is a new method of organ preservation whereby an organ is ‘mechanically flushed’ outside the human body with an oxygenated fluid. Oxygenated machine perfusion is gaining increasing attention as an alternative method of organ preservation, as it can be used to improve and assess organ viability of marginal donor organs prior to transplantation. Moreover, the technique of machine perfusion also enables the development of more extreme methods of organ preservation such as cryopreservation (preservation below 0 degrees Celsius) and biobanking within a new areas of transplant surgery, such as vascularized tissue transplantation. This ultimately leads to more and better quality organs and vascularized tissue grafts. In this thesis I investigate the effects of oxygenated machine perfusion on both donor livers (part A) and limbs (part B) in more detail. The results of this thesis contribute to a better understanding of the effect of new methods of organ preservation on the quality of the organ to be transplanted.