JPH05271001A - Initial perfusate solution for transplanting organ - Google Patents

Initial perfusate solution for transplanting organ

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Publication number
JPH05271001A
JPH05271001A JP8636592A JP8636592A JPH05271001A JP H05271001 A JPH05271001 A JP H05271001A JP 8636592 A JP8636592 A JP 8636592A JP 8636592 A JP8636592 A JP 8636592A JP H05271001 A JPH05271001 A JP H05271001A
Authority
JP
Japan
Prior art keywords
solution
organ
present
initial
perfusion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP8636592A
Other languages
Japanese (ja)
Inventor
Shigeru Hiroki
繁 廣木
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MORISHITA ROUSSEL KK
Original Assignee
MORISHITA ROUSSEL KK
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by MORISHITA ROUSSEL KK filed Critical MORISHITA ROUSSEL KK
Publication of JPH05271001A publication Critical patent/JPH05271001A/en
Pending legal-status Critical Current

Links

Abstract

PURPOSE:To obtain a stable and inexpensive initial perfusate solution excellent in maintaining the action on function of an organ for transplantation. CONSTITUTION:The objective initial perfusate solution for transplanting an organ which is an aqueous solution characterized by having 340-450mOsm/l osmotic pressure and pH 7.1-7.4 and containing electrolytes, mannitol and hydroxyethyl starch within compositional ranges shown in the table.

Description

【発明の詳細な説明】Detailed Description of the Invention

【0001】[0001]

【産業上の利用分野】本発明は、臓器移植の初期灌流に
用いる溶液に関するものである。
FIELD OF THE INVENTION The present invention relates to a solution used for initial perfusion of organ transplant.

【0002】[0002]

【従来の技術】移植用臓器の保存方法において、一般的
に用いられている単純冷却保存法は、摘出臓器の代謝を
低温保存により抑制して、臓器の機能を維持しようとす
るものである。この、単純冷却保存の第一段階として、
血液のウォッシュアウトおよび臓器内部から冷却を行う
目的で初期灌流が行われる。また、生存能力の低い臓器
においては、死体内で血液をウォッシュアウトおよび臓
器の冷却を行うため初期灌流が施行される。臓器移植に
おけるこれらの初期灌流は、実質細胞のビアビリティを
保持するとともに、血管内皮の損傷および間質の浮腫に
ともなう微小循環障害を最小限にとどめることが必要で
ある。臓器移植用の初期灌流溶液としては、コリンズ
(Collins)液、ユーロ-コリンズ(Euro-C
ollins)液および輸液の乳酸加リンゲル液が用い
られてきた。しかしこれらの溶液では、臓器の機能維持
に対する十分な効果は期待できず、生存能力の高い腎臓
においては利用できるものの、腎臓以外の臓器では移植
後の臓器生存能力維持時間が短いという問題点があっ
た。これまで、初期灌流溶液の適切な組成に関する検討
は少なく、合成HES(ヒドロキシエチル澱粉)、ラク
トビオン酸、ラフィノース等を含有し、灌流液および臓
器取り出し後の低温貯蔵の両方に用い得る臓器保存用溶
液が開示されている。(特開平3-188001)しかし、前記
溶液は多量に使用する初期灌流溶液としては高価であ
り、また、冷蔵保存を必要とするなど製剤学的安定性に
難点がある。
2. Description of the Related Art In the method of preserving organs for transplantation, the simple cryopreservation method which is generally used is intended to suppress the metabolism of the excised organ by cryopreservation to maintain the function of the organ. As the first step of this simple cold preservation,
Initial perfusion is performed for the purpose of washing out blood and cooling from inside the organ. For organs with low viability, initial perfusion is performed to wash out blood and cool the organs in the cadaver. These initial perfusions in organ transplants are required to preserve parenchymal cell viability and minimize microcirculatory disturbances associated with vascular endothelium damage and stromal edema. As the initial perfusion solution for organ transplant, Collins solution, Euro-Colins (Euro-C) are used.
liquids and infusional lactated Ringer's solution have been used. However, these solutions cannot be expected to have a sufficient effect on the maintenance of organ functions, and although they can be used in highly viable kidneys, they have the problem that organs other than kidneys have a short organ viability maintenance time after transplantation. It was So far, there have been few studies on the appropriate composition of the initial perfusion solution, and it contains synthetic HES (hydroxyethyl starch), lactobionic acid, raffinose, etc., and is a solution for organ preservation that can be used for both perfusion solution and low temperature storage after organ removal. Is disclosed. (JP-A-3-188001) However, the above solution is expensive as an initial perfusion solution to be used in a large amount, and it has a problem in pharmaceutical stability because it requires refrigeration storage.

【0003】[0003]

【発明が解決しようとする課題】したがって、本発明の
課題は、臓器移植用の初期灌流溶液として移植用臓器の
機能維持作用に優れ、安定かつ安価な溶液を提供するこ
とにある。
SUMMARY OF THE INVENTION Therefore, an object of the present invention is to provide a stable and inexpensive solution as an initial perfusion solution for organ transplant, which has an excellent function-maintaining action for organs for transplant.

【0004】[0004]

【課題を解決するための手段】本発明者らは、電解質、
浸透圧調節剤、及び膠質浸透圧剤の望ましい選択と組成
範囲について鋭意研究した結果、初期の目的を達成する
本発明を完成することができた。
SUMMARY OF THE INVENTION The present inventors have proposed an electrolyte,
As a result of intensive studies on the desired selection and composition range of the osmotic pressure adjusting agent and the oncotic pressure osmotic agent, the present invention that achieves the initial objectives was completed.

【0005】すなわち、本発明の臓器移植用の初期灌流
溶液は、浸透圧が340〜450mOsm/l、pHが7.
0〜7.6の水溶液であって、下記成分を下記組成物範
囲内で含有することを特徴とするものである。
That is, the initial perfusion solution for organ transplantation of the present invention has an osmotic pressure of 340 to 450 mOsm / l and a pH of 7.
It is an aqueous solution of 0 to 7.6 and is characterized by containing the following components within the following composition range.

【0006】[0006]

【表2】 [Table 2]

【0007】本発明のより好ましい実施態様の組成範囲
を示せば次の通りである。
The composition range of a more preferred embodiment of the present invention is as follows.

【0008】[0008]

【表3】 [Table 3]

【0009】上記成分中、炭酸アニオンは、炭素数2〜
6の乳酸、酢酸、プロピオン酸、β−ヒドロキシ酪酸、
クエン酸、グルコン酸等の有機酸およびその塩、並びに
炭素数8以下の中鎖もしくは短鎖脂肪酸およびその塩と
置き換えることができる。また、ヒドロキシエチル澱粉
は、置換度が0.4〜0.8の範囲内のもので、平均分
子量が200000〜900000ドルトンのものが好
ましく、さらに好ましくは約350000〜80000
0ドルトンのものである。
In the above components, the carbonate anion has 2 to 2 carbon atoms.
6, lactic acid, acetic acid, propionic acid, β-hydroxybutyric acid,
It can be replaced with organic acids such as citric acid and gluconic acid and salts thereof, and medium- or short-chain fatty acids having 8 or less carbon atoms and salts thereof. The hydroxyethyl starch preferably has a degree of substitution in the range of 0.4 to 0.8 and an average molecular weight of 200,000 to 900,000 daltons, more preferably about 350,000 to 80,000.
It's 0 Dalton.

【0010】本発明溶液の製造にあたり、使用する電解
質は、リン酸、炭酸および炭素数2〜6の乳酸、酢酸、
プロピオン酸、β−ヒドロキシ酪酸、クエン酸、グルコ
ン酸等の有機酸およびそのナトリウム塩もしくはカリウ
ム塩、並びに炭素数8以下の中鎖もしくは短鎖脂肪酸お
よびその塩であるが、上記組成範囲内において、各酸の
ナトリウム塩とカリウム塩の組合せは任意である。本発
明溶液は、公知の輸液剤製造方法に準拠して容易に製造
することができる。
The electrolyte used in the production of the solution of the present invention is phosphoric acid, carbonic acid and lactic acid having 2 to 6 carbon atoms, acetic acid,
Propionic acid, β-hydroxybutyric acid, citric acid, organic acids such as gluconic acid and sodium salts or potassium salts thereof, and medium or short chain fatty acids having 8 or less carbon atoms and salts thereof, within the above composition range, The combination of the sodium salt and potassium salt of each acid is arbitrary. The solution of the present invention can be easily produced according to a known method for producing an infusion agent.

【0011】[0011]

【実施例】【Example】

実施例1 約50℃の蒸留水800mlにヒドロキシエチル澱粉
(平均分子量429000、置換度0.55)60g、
塩化カリウム1.42g、リン酸水素二カリウム5.1
8g、リン酸二水素カリウム1.43gおよびマンニト
ール42.5gを加えて溶解した後、炭酸水素ナトリウ
ム0.76gおよび蒸留水を加えて全量を1lとした。
これを直ちにろ過し、ガラス容器に充填、密栓後、高圧
蒸気滅菌して臓器移植用の初期灌流溶液を製した。
Example 1 60 g of hydroxyethyl starch (average molecular weight 429000, degree of substitution 0.55) in 800 ml of distilled water at about 50 ° C.
1.42 g of potassium chloride, 5.1 dipotassium hydrogen phosphate
After 8 g, 1.43 g of potassium dihydrogen phosphate and 42.5 g of mannitol were added and dissolved, 0.76 g of sodium hydrogen carbonate and distilled water were added to make the total amount to 1 liter.
This was immediately filtered, filled in a glass container, sealed, and sterilized by high pressure steam to prepare an initial perfusion solution for organ transplantation.

【0012】[0012]

【試験例】[Test example]

試験例1 本発明溶液の初期灌流溶液としての有用性を調べるた
め、雑種成犬に塩化カリウム溶液を静脈注射し心停止
後、30分間の温阻血(以下WIT30分と略記する)
を加え、実施例1で調製した本発明溶液(以下単に本発
明溶液という)を用いて死体内灌流(in situ m
achine wash out)を施行した。死体内灌
流は死体内灌流装置を用い、腹部大動脈内カテーテルよ
り300〜600ml/min.の流量(灌流液温度:
4℃)で約30分間施行した。本発明溶液の効果を明ら
かにするため、比較溶液として、乳酸加リンゲル液(以
下LRと略記する)、モディファイドコリンズ液(Mo
dified Collins液、以下CMと略記す
る)およびウィスコンシン大学で開発されたUW液(以
下UVと略記する)を用いてそれぞれ同様な死体内灌流
を行った。死体内灌流した後、肝臓、膵臓、および腎臓
を摘出してそれぞれの組織水分含有量をオーブン乾燥法
(Oven dry method)により測定した。な
お、CMはコリンズ液(Collin液)の電解質処方
を参考にマンニトールを浸透圧調節剤およびラジカルス
カベンジャー(Radical Scavenger)
として含んだ初期灌流溶液であって、 マンニトール 4.250w/v% KCl 0.142w/v% K2HPO4 0.518w/v% KH2PO4 0.143w/v% NaHCO3 0.076w/v% を含んでなる溶液である。
Test Example 1 To examine the usefulness of the solution of the present invention as an initial perfusion solution, a mixed dog was intravenously injected with a potassium chloride solution, and after cardiac arrest, warm ischemia for 30 minutes (hereinafter abbreviated as WIT 30 minutes).
In addition, the solution of the present invention prepared in Example 1 (hereinafter simply referred to as the solution of the present invention) was used to perform perfusion in the body.
A machine wash out) was performed. For cadaveric perfusion, a cadaveric perfusion device was used, and 300 to 600 ml / min. Flow rate (perfusate temperature:
It was carried out at 4 ° C. for about 30 minutes. In order to clarify the effect of the solution of the present invention, lactated Ringer's solution (hereinafter abbreviated as LR) and modified Collins solution (Mo
Similar intracorporeal perfusion was performed using each of the defined Collins solution (hereinafter abbreviated as CM) and the UW solution developed at the University of Wisconsin (hereinafter abbreviated as UV). After perfusion in the cadaver, the liver, pancreas, and kidney were removed, and the water content of each tissue was measured by the oven dry method. CM is osmotic pressure adjusting agent and radical scavenger (Radical Scavenger) with reference to the electrolyte prescription of Collins solution (Collin solution).
An initial perfusion solution containing mannitol 4.250 w / v% KCl 0.142 w / v% K 2 HPO 4 0.518 w / v% KH 2 PO 4 0.143 w / v% NaHCO 3 0.076 w / It is a solution containing v%.

【0013】各摘出臓器の組織水分含有量を図1に示し
た。本発明溶液で死体内灌流を施行した場合、LR、C
MおよびUWを用いた場合に比べ、摘出臓器の組織水分
含有量が低く臓器の微小循環障害の原因となる浮腫性変
化は軽度であった。
The tissue water content of each excised organ is shown in FIG. When cadaveric perfusion was performed with the solution of the present invention, LR, C
Compared with M and UW, the tissue water content of the excised organ was low, and the edematous changes causing organ microcirculatory disturbance were mild.

【0014】[0014]

【図1】[Figure 1]

【0015】さらに、各摘出臓器の組織像を光学顕微鏡
および電子顕微鏡で観察した結果、CMを用いた場合
は、光学顕微鏡観察では、肝臓および膵臓間質の著明な
浮腫、腎ボーマン嚢の開大、糸球体係蹄の萎縮等が見ら
れ、電子顕微鏡観察においても、血管内皮の菲薄化、血
管周囲の著明な浮腫が観察された。しかし、本発明溶液
およびUWではそれらの変化は軽微であり、本発明溶液
が組織像観察からも、UWと同様の臓器保存性を有する
ことが明らかとなった。
Furthermore, as a result of observing the histological images of the respective excised organs with an optical microscope and an electron microscope, when CM was used, the edema of the liver and the pancreas interstitium and the opening of the Bowman's capsule of the kidney were observed by the optical microscope observation. Large and atrophied glomerular loops were observed, and thinning of the vascular endothelium and marked edema around the blood vessels were also observed by electron microscopy. However, changes in the solution of the present invention and UW were slight, and it was clarified from the observation of the histological image that the solution of the present invention has the same organ preservation property as that of UW.

【0016】試験例2 試験例1と同様の方法で本発明溶液および比較液として
CMを用いて死体内灌流を施行した後、各溶液で灌流し
た膵臓を摘出し、膵臓組織のSOD(Superoxi
de disumutase)活性をテトラゾリウム還
元法(SOD測定キット 和光純薬社製を使用)にて測
定した。
Test Example 2 In the same manner as in Test Example 1, a solution of the present invention and CM as a comparative solution were used to perform perfusion in the corpse, and then the pancreas perfused with each solution was excised, and SOD (Superoxi) of pancreatic tissue was extracted.
De disputase) activity was measured by the tetrazolium reduction method (SOD measurement kit manufactured by Wako Pure Chemical Industries, Ltd. was used).

【0017】図2に膵臓組織のSOD活性を示す。本発
明溶液で死体内灌流した膵臓組織のSOD活性は正常膵
臓のそれと比べ比較的良く保たれており、本発明溶液で
初期灌流することにより温阻血障害のひとつであるフリ
ーラジカル発生による細胞の自己融解を低減させること
が明らかとなった。
FIG. 2 shows the SOD activity of pancreatic tissue. The SOD activity of the pancreas tissue perfused in the cadaver with the solution of the present invention was relatively better than that of the normal pancreas, and the initial perfusion with the solution of the present invention caused the autologous cells by free radical generation, which is one of the warm ischemic disorders. It was found to reduce melting.

【0018】[0018]

【図2】[Fig. 2]

【0019】試験例3 試験例1と同様の方法で本発明溶液および比較液として
UWを用いて死体内灌流を行った後膵臓を摘出し、自己
膵臓摘出犬に同種部分膵臓移植を施行した。移植後、各
移植犬の血流を再開させ10分経過したときの移植膵臓
の静脈血を採血し、その血清中の過酸化脂質をマロンジ
アルデヒド法(Malondialdehide法)に
より測定した。
Test Example 3 In the same manner as in Test Example 1, intracorporeal perfusion was performed using UW as the solution of the present invention and a comparative solution, and then the pancreas was excised, and allogeneic partial pancreas transplantation was performed on an autologous pancreatectomized dog. After transplantation, the blood flow of each transplanted dog was restarted, and 10 minutes had passed, venous blood of the transplanted pancreas was collected, and lipid peroxide in the serum was measured by the malondialdehyde method (Malondialdehyde method).

【0020】図3に血清過酸化脂質の測定結果を示す。
過酸化脂質は活性酸素などのフリーラジカルにより不飽
和脂肪酸が過酸化され生成するが、この過酸化脂質が生
体膜に蓄積して細胞壊死を引き起こすと考えられてい
る。本発明溶液を用いて死体内灌流した場合、UWを用
いた場合に比べて移植膵臓の血流を再開した後の過酸化
脂質が低く、本発明溶液が過酸化脂質の引き起こす膵臓
機能障害の抑制に優れた効果を顕すことが明らかとなっ
た。
FIG. 3 shows the measurement results of serum lipid peroxide.
Unsaturated fatty acids are produced by free radicals such as active oxygen in lipid peroxides, which are believed to accumulate in biological membranes and cause cell necrosis. When the solution of the present invention was perfused in the dead body, the lipid peroxide after reopening the blood flow of the transplanted pancreas was lower than that in the case of using UW, and the solution of the present invention suppressed the pancreatic dysfunction caused by the lipid peroxide. It was revealed that the excellent effect was exhibited.

【0021】[0021]

【図3】[Figure 3]

【0022】試験例4 試験例3と同様に本発明溶液および比較液としてMC並
びにUWを用て膵臓移植を施行した後、同種部分膵臓移
植した犬(以下単に移植犬という)の膵臓組織血流量を
水素ガスクリアランス法によって測定し、その結果を図
4に示した。
Test Example 4 As in Test Example 3, pancreas transplantation was performed using MC and UW as the solution of the present invention and a comparative solution, and then pancreatic tissue blood flow of a dog having a partial pancreatic allogeneic transplantation (hereinafter simply referred to as a transplanted dog). Was measured by the hydrogen gas clearance method, and the results are shown in FIG.

【0023】[0023]

【図4】[Figure 4]

【0024】また、移植後一週間を経過した各移植犬に
対して糖負荷試験(IVGTT)を行い、血糖値減少率
K値をハミルトン(Hamilton)らの方法により
算出しその結果を図5に示した。
Further, a glucose tolerance test (IVGTT) was carried out on each transplanted dog one week after transplantation, and the blood glucose decrease rate K value was calculated by the method of Hamilton et al., And the results are shown in FIG. Indicated.

【0025】[0025]

【図5】[Figure 5]

【0026】本発明溶液はCMおよびUWを用いた場合
に比べて移植膵臓血流量が多く、また、移植後に行った
糖負荷試験においても、本発明溶液を用いた場合とUW
を用いた場合とはほぼ同等のK値を示した。このよう
に、本発明溶液で死体内灌流することによりUWを用い
た場合と同等の膵臓機能を保持できることが明らかとな
った。
The solution of the present invention has a larger blood flow volume in the transplanted pancreas compared to the case of using CM and UW, and in the glucose tolerance test conducted after transplantation, the solution of the present invention and that of UW were used.
The value of K was almost the same as that of the case of using. As described above, it became clear that perfusion of the dead body with the solution of the present invention can maintain the same pancreatic function as in the case of using UW.

【0027】試験例5 本発明溶液の安定性を調べるために、本発明溶液を充填
したバイアルを40℃で6ヶ月間保存した後、各成分の
含有量、pH、透過率、および結晶析出の有無を観察す
る外観試験を行った。その結果を表4に示した。各試験
項目において品質の低下は認められず40℃に6ヶ月保
存しても安定性に問題のないことが明らかとなった。従
って、本発明溶液は室温においても3年以上は安定であ
ることが推測された。
Test Example 5 In order to investigate the stability of the solution of the present invention, the vial filled with the solution of the present invention was stored at 40 ° C. for 6 months, and then the content of each component, pH, transmittance, and crystal precipitation were observed. An appearance test was performed to observe the presence or absence. The results are shown in Table 4. No deterioration in quality was observed in each test item, and it was revealed that there was no problem in stability even when stored at 40 ° C. for 6 months. Therefore, it was speculated that the solution of the present invention is stable even at room temperature for 3 years or more.

【0028】[0028]

【表4】 [Table 4]

【0029】[0029]

【発明の効果】このように、本発明によれば、多量の使
用が必要な臓器移植用の初期灌流溶液において、移植用
臓器の機能維持作用に優れ、安定かつ安価な溶液を提供
することができる。
As described above, according to the present invention, it is possible to provide a stable and inexpensive solution having an excellent function-maintaining action for organs for transplantation in an initial perfusion solution for organ transplantation, which requires a large amount of use. it can.

【図面の簡単な説明】[Brief description of drawings]

【図1】図1は死体内灌流した後摘出した肝臓、膵臓お
よび腎臓の組織水分含有量を表わす。
FIG. 1 shows the tissue water content of the liver, pancreas and kidney removed after perfusion in the cadaver.

【図2】図2は正常膵臓と本発明溶液にて死体内灌流し
た膵臓組織のSOD活性を表わす。
FIG. 2 shows SOD activity of normal pancreas and pancreatic tissue perfused in the cadaver with the solution of the present invention.

【図3】図3は正常膵臓と本発明溶液およびUWにて死
体内灌流した膵臓の静脈血血清過酸化脂質を表わす。
FIG. 3 shows venous blood serum lipid peroxide of normal pancreas and pancreas perfused with the solution of the present invention and UW in the body.

【図4】図4は本発明溶液、LR、CMおよびUWにて
死体内灌流した膵臓の膵臓組織血流量を表わす。
FIG. 4 shows the blood flow of pancreatic tissue in a pancreas perfused with a cadaver by the solution of the present invention, LR, CM and UW.

【図5】図5は膵臓移植後1週間を経過した移植犬に対
して糖負荷試験(IVGTT)を行った際の血糖値減少
率K値を表わす。
FIG. 5 shows a blood glucose decrease rate K value when a glucose tolerance test (IVGTT) was performed on transplanted dogs one week after pancreas transplantation.

Claims (2)

【特許請求の範囲】[Claims] 【請求項1】 浸透圧が340〜450mOsm/l、pH
が7.0〜7.6の水溶液であって、下記成分を下記組
成物範囲内で含有することを特徴とする臓器移植用の初
期灌流溶液。 【表1】
1. An osmotic pressure of 340 to 450 mOsm / l, pH
Is an aqueous solution of 7.0 to 7.6, and contains the following components within the following composition range: an initial perfusion solution for organ transplantation. [Table 1]
【請求項2】 ヒドロキシエチル澱粉の平均分子量が2
00000〜900000ドルトンで、置換度が0.4
〜0.8である請求項1記載の臓器移植用の初期灌流溶
液。
2. The average molecular weight of hydroxyethyl starch is 2
00000 to 900,000 Daltons with a degree of substitution of 0.4
The initial perfusion solution for organ transplantation according to claim 1, which is about 0.8.
JP8636592A 1991-12-05 1992-03-09 Initial perfusate solution for transplanting organ Pending JPH05271001A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP34917291 1991-12-05
JP3-349172 1991-12-05

Publications (1)

Publication Number Publication Date
JPH05271001A true JPH05271001A (en) 1993-10-19

Family

ID=18401959

Family Applications (1)

Application Number Title Priority Date Filing Date
JP8636592A Pending JPH05271001A (en) 1991-12-05 1992-03-09 Initial perfusate solution for transplanting organ

Country Status (1)

Country Link
JP (1) JPH05271001A (en)

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