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54. Accelerating the development of reversible long-term human organ storage

Lewis, Jedediah, Morigi, Valentina, Giwa, Sebastian, Allal, Zak, Tocchio, Alessandro
Cryobiology 2015 v.71 no.1 pp. 178
animal ovaries, blood vessels, business enterprises, chilling injury, cryopreservation, cryoprotectants, ecosystems, entrepreneurship, experts, government agencies, heart valves, humans, ice, issues and policy, kidneys, liver, markets, patients, physicians, public health, rabbits, rats, sheep, shelf life, spermatozoa, stem cells, swine, temperature, tissue banks, tissue engineering, toxicity, vitrification
The Organ Preservation Alliance is a non-profit foundation incubated at SU labs at NASA Research Park in silicon valley and lead by an interdisciplinary team of scientists, doctors, policy influencers, and entrepreneurs. The Alliance aims to catalyze breakthroughs in the long-term preservation of human organs and other tissue systems. This will save and enrich the lives of millions of patients who would benefit from organ transplants and will accelerate progress towards storing tissue-engineered organs for on-demand replacement, in the long-term potentially impacting billions.Progress in this space would save lives in multiple ways. An enormous global shortage of transplant organs is growing steadily, leading to massive economic and public health burdens. Not only are many otherwise usable organs lost because of the lack of storage capabilities, but the need for immune suppression treatments and non-optimal matching worsens outcomes for patients who receive a transplant. Organ banking could help solve each of the problems, and it could transform trauma care by enabling more and better limb transplants for wounded soldiers, civilians, and first responders in emergency situations. Long-term tissue preservation is also a valuable complement to and accelerator of tissue engineering, dramatically increasing the market size and public health impact of engineered tissues by providing them a shelf life.Cryopreservation has been used to bank cells in suspension for decades, with stem cells, sperm, and embryos stored reversibly. And in recent years, breakthroughs in cryoprotectants, ice blockers and vitrification have made it possible to preserve blood vessels, heart valves, corneas, ovarian tissue and more. In nature, many organisms can tolerate extreme low-temperature transitions and undergo metabolic stasis with no long-term tissue damage. The feasibility of human organ cryopreservation has been demonstrated through progress with rat hearts, pig and rodent livers, sheep ovaries and rabbit kidneys, and rodent limbs.While it will be a challenge to build on these early results and enable organ banking to become routine, the challenge can be broken down into six tractable sub-challenges. These include limiting excessive ice formation, cryoprotectant toxicity, thermomechanical stress, ischemic injury, chilling injury, and injury during organ revival. Total tissue injury needs only to be reduced to acceptable levels to enable transplantation. This means injury from each of these sources does not need to be completely eliminated, and the more progress is made on one sub-challenge, the lower the burden to make progress on others. This well-balanced portfolio of research opportunities makes tissue cryopreservation an especially attractive biomedical challenge.We aim to accelerate breakthroughs by building out a vital ecosystem of support including government agencies, angel investors and venture capitalists, biotech companies, and hundreds of other stake-holder organizations whose missions would benefit enormously from breakthroughs in this space. The first Global Summit on the Grand Challenges in Organ Banking has brought together the experts in cryobiology and other key domains from around the world, in order to discuss how to tackle the challenges of organ preservation in a focused way.