Cryopreservation Strategies to Improve Access to Organ Transplantation

Organ transplantation is the only definitive cure for end-stage organ failure. The primary obstacle is the scarcity of viable donor organs, resulting in many patients dying on the transplant waitlist. The last decade has brought a range of transformative technologies to address this shortage: machine perfusion has risen as an option to greatly increase the human donor organ utilization, while xenotransplantation further promises to fundamentally alter the calculus in supply constraints. Given this increasing availability, the logistics of allocation rises as the next key technological barrier. Cryopreservation strategies aim to increase the viable storage time for organs and thereby enable the creation of a cold-supply chain for clinical transplantation. This technology has the potential to overcome limitations related to preservation and transportation, histocompatibility matching, complex organ allocation and wastage, and in tandem with xenotransplantation, provide an unlimited off-the-shelf supply of organs. This review aims to cover the latest research updates in the use of cryopreservation, how it compares to current clinical preservation strategies, and discuss how its implementation into the world of transplantation may require new logistical, ethical and regulatory frameworks.