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When agricultural goods begin to be transported by those temperatures where value added products can be transported, cold room assessments in industrial applications must be validated. Computational feedback can improve the process consistency. Data on coolant and boundary dynamics can be evaluated by means of computer fluid dynamics (CFD). Air speed and air temperature are the distribution parameters in this analysis. When the vegetable temperature is preserved with less variations in the storage room, as well as the required air distribution, the best effects of proper preservations are achieved. With proper air circulation, temperature difference is minimised. Air speed is necessary to protect the cold storage of agricultural products. This project's main objective was to observe the decrease in temperature when PCMs are used within the cold storage space. Most of the experimental results demonstrated that in the event of regular openings of doors, also in the context of electricity failures using PCM, the temperature retained inside the cool space was 1–4.5 °C lower than without PCM, even in the cases of electrical failures using PCM. The present study focuses on applying guidelines to enhance cold room technology for improved outcomes in cold storage. Present work discussed about the reference methods and the techniques used in previous literature with future recommendations.

Objective Ex vivo lung perfusion has emerged as a novel technique to safely preserve lungs before transplantation. Recent studies have demonstrated an accumulation of inflammatory molecules in the perfusate during ex vivo lung perfusion. These proinflammatory molecules, including damage-associated molecular patterns and inflammatory cytokines, may contribute to acute and chronic allograft dysfunction. At present, ex vivo lung perfusion is performed clinically at normothermic temperature (37°C). The effect of lowering temperature to the subnormothermic range during ex vivo lung perfusion has not been reported. In this study, we hypothesized that lower ex vivo lung perfusion temperature will lead to a reduction in allograft inflammation and result in improved post-transplant graft function. Methods Lewis rat heart-lung blocs underwent 4 hours of ex vivo lung perfusion in 3 temperature groups: 37°C (MP37), 30°C (MP30), and 25°C (MP25). In the control group, lung grafts were preserved by static cold storage before transplantation. After ex vivo lung perfusion or static cold storage, the left lung was transplanted for 2 hours before the animal was killed. Sera and tissue were collected and analyzed. Results There were no differences in partial pressure of arterial oxygenation to fraction of inspired oxygen ratios during 4 hours of ex vivo lung perfusion between temperature groups. Tumor necrosis factor α significantly increased in the MP37 group during ex vivo lung perfusion, whereas this was not seen at lower temperatures. Extracellular DNA and high-mobility group box 1 perfusate concentrations increased significantly during ex vivo lung perfusion in all groups, but the rate of increase was diminished at lower temperature. Two hours post-transplant, there were no significant differences in partial pressure of arterial oxygenation to fraction of inspired oxygen ratios of the lung graft or serum damage-associated molecular pattern levels among groups. On histologic grading after transplantation, greater injury was observed in the MP30 and MP37 groups, but not MP25, when compared with static cold storage. Conclusions Subnormothermic ex vivo lung perfusion at 25°C reduces the production of inflammatory mediators during ex vivo lung perfusion and is associated with reduced histologic graft injury after transplantation.

Introduction Traditional liver transplant strategies with cold preservation usually result in ischemia reperfusion injury (IRI) to the donor liver. Regular normothermic machine perfusion (NMP) donor livers suffer IRI twice. Here, we aimed to introduce a novel technique called continuous normothermic machine perfusion (NMP) without recooling to avoid a second IRI and its application in livers from extended criteria donors (ECDs). Materials and methods Seven donor livers transplanted following continuous NMP without recooling, 7 donor livers transplanted following standard NMP and 14 livers under static cold storage (SCS) were included in this study. Perioperative outcomes were recorded and analyzed between groups. Result During the NMP without a recooling procedure, all livers cleared lactate quickly to normal levels in a median time of 100 minutes (IQR 60~180) and remained stable until the end of perfusion. In the NMP without recooling and standard NMP groups, posttransplant peak aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were both significantly lower than those in the SCS group (P=0.0015 and 0.016, respectively). The occurrence rate of early allograft dysfunction (EAD) was significantly lower in the NMP without recooling group than in the SCS group (P=0.022), while there was no difference in the NMP group with or without recooling (P=0.462). Conclusion Our pilot study revealed a novel technique designed to avoid secondary IRI. This novel technique is shown to have at least a comparable effect to the standard NMP, though more data are needed to show its superiority in the future.

Heart transplantation is the gold standard of treatments for end-stage heart failure, but its use is limited by extreme shortage of donor organs. The time "window" between procurement and transplantation sets the stage for myocardial ischemia/reperfusion injury, which constrains the maximal storage time and lowers use of donor organs. Given mesenchymal stem cell (MSC)-derived paracrine protection, we aimed to evaluate the efficacy of MSC-conditioned medium (CM) and extracellular vesicles (EVs) when added to ex vivo preservation solution on ameliorating ischemia/reperfusion-induced myocardial damage in donor hearts.Mouse donor hearts were stored at 0°C-4°C of1-hour cold ischemia (1hr-I), 6hr-I + vehicle, 6hr-I + MSC-CM, 6hr-I + MSC-EVs, and 6hr-I + MSC-CM from MSCs treated with exosome release inhibitor. The hearts were then heterotopically implanted into recipient mice. At 24 hours postsurgery, myocardial function was evaluated. Heart tissue was collected for analysis of histology, apoptotic cell death, microRNA (miR)-199a-3p expression, and myocardial cytokine production.Six-hour cold ischemia significantly impaired myocardial function, increased cell death, and reduced miR-199a-3p in implanted hearts versus1hr-I. MSC-CM or MSC-EVs in preservation solution reversed the detrimental effects of prolong cold ischemia on donor hearts. Exosome-depleted MSC-CM partially abolished MSC secretome-mediated cardioprotection in implanted hearts. MiR-199a-3p was highly enriched in MSC-EVs. MSC-CM and MSC-EVs increased cold ischemia-downregulated miR-199a-3p in donor hearts, whereas exosome-depletion neutralized this effect.MSC-CM and MSC-EVs confer improved myocardial preservation in donor hearts during prolonged cold static storage and MSC-EVs can be used for intercellular transport of miRNAs in heart transplantation.

Cardiac transplantation is the gold standard for treatment for select patients with end-stage heart failure, yet donor supply is limited. Ex vivo machine perfusion is an emerging technology capable of safely preserving organs and expanding the viable donor pool. The TransMedics® Organ Care System™ is an investigational device which mimics physiologic conditions while maintaining the heart in a warm, beating state rather than cold storage. The use of Organ Care System allows increased opportunities for using organs from marginal donors, distant procurement sites, donation after cardiac death, and in recipients with complex anatomy. In the future, bioengineering technologies including use of mesenchymal stem cells, viral vector delivery of gene therapy, and alternate devices may further broaden the field of ex vivo machine perfusion.

BACKGROUND: There is a continued interest in ex situ heart perfusion as an alternative strategy for donor heart preservation. We hypothesize that oxygenated machine perfusion of donor hearts at a temperature that avoids both normothermia and deep hypothermia offers adequate and safe preservation. METHODS: Cardioplegia-arrested porcine donor hearts were randomly assigned to six hours of preservation using cold storage (CS, n = 5) or machine perfusion using an oxygenated acellular perfusate at 21°C (MP, n = 5). Subsequently, all grafts were evaluated using the Langendorff method for 120 min. Metabolic parameters and histology were analyzed. Systolic function was assessed by contractility and elastance. Diastolic function was assessed by lusitropy and stiffness. RESULTS: For both groups, in vivo baseline and post-Langendorff biopsies were comparable, as were lactate difference and myocardial oxygen consumption. Injury markers gradually increased and were comparable. Significant weight gain was seen in MP (p = 0.008). Diastolic function was not impaired in MP, and lusitropy was superior from 30 min up to 90 min of reperfusion. Contractility was superior in MP during the first hour of evaluation. CONCLUSION: We conclude that the initial functional outcome of MP-preserved hearts was transiently superior compared to CS, with no histological injury post-Langendorff. Our machine perfusion strategy could offer feasible and safe storage of hearts prior to transplantation. Future studies are warranted for further optimization. ispartof: ARTIFICIAL ORGANS vol:46 issue:2 pages:246-258 ispartof: location:United States status: published

Split-liver transplantation offers a solution to the organ shortage problem. However, the outcomes of extended right lobe liver transplantation (ERLT) and whether it is a suitable alternative to full-size liver transplantation (FSLT) remain controversial. We compared the outcomes of ERLT and FSLT in adult recipients of 43,409 first deceased donor liver transplantations using Cox regression. We also analyzed 612 ERLT and 1224 FSLT 1:2 matched cases to identify factors that affect ERLT outcome. The risk of graft loss was significantly higher following ERLT than following FSLT during the first posttransplantation year in the matched and unmatched collective (hazard ratio [HR], 1.39 and 1.27 and P = 0.01 and 0.006, respectively). Every additional hour of cold ischemia time (CIT) increased the risk of 1-year graft loss by 10% in the ERLT group compared with only 3% in the FSLT group (P = 0.003 and, Projekt DEAL

Background Acute febrile illnesses (AFIs), including dengue, scrub typhus and leptospirosis, cause significant morbidity and mortality in Southeast Asia. Serological surveillance can be used to investigate the force and distribution of infections. Dried blood spot (DBS) samples are an attractive alternative to serum because they are easier to collect and transport and require less cold storage. We conducted a pilot study to determine the feasibility of integrating serological surveillance for dengue, scrub typhus and leptospirosis into a population-representative lymphatic filariasis seroprevalence survey in Timor-Leste using DBSs. Methods A total of 272 DBSs were collected from healthy community participants. DBSs were analysed at the National Health Laboratory using commercially available enzyme-linked immunosorbent assays. To validate assays for DBSs, 20 anonymised serum samples of unknown serostatus were used to create dried serum spots (DSSs). These were analysed with optical densities compared with those of serum. Where low variance was observed (dengue assay) the published kit cut-offs for serum were applied to the analysis of DBSs. For the other assays (scrub typhus and leptospirosis), index values (IVs) were calculated and cut-offs were determined to be at 2 standard deviations (SDs) above the mean. Results Of the 272 samples analysed, 19 (7.0% [95% confidence interval {CI} 4.3 to 10.7]) were positive for dengue immunoglobulin G (IgG), 11 (4.0% [95% CI 2.1 to 7.1]) were positive for scrub typhus IgG and 16 (5.9% [95% CI 3.4 to 9.4%]) were positive for leptospira IgG. Conclusions While dengue seroprevalence was lower than in nearby countries, results represent the first evidence of scrub typhus and leptospirosis transmission in Timor-Leste. Integrated programmes of serological surveillance could greatly improve our understanding of infectious disease epidemiology in remote areas and would incur minimal additional fieldwork costs. However, when planning such studies, the choice of assays, their validation for DBSs and the laboratory infrastructure and technical expertise at the proposed location of analysis must be considered.

Globally, vaccination plays a vital role in controlling the Covid-19 pandemic. However, the cold supply chain is essential for vaccine storage and logistics services. In a country like India, the last-mile logistics of vaccines is a challenging task. The cold chain is indispensable for the Covid-19 vaccine drive to the rural areas. The demand for cold storage increases rapidly due to the rapid Covid-19 vaccine drive. The conventional cold storage facility has a more significant threat to the grid power quality and environmental impacts. The energy demand and greenhouse gas emission of traditional cold storage lead to global warming. The micro cold storage facility has to be developed rapidly to accelerate the vaccine drive to the last mile of the county with reliable and affordable energy sources. In addition, climate change mitigation is ensured by the renewable energy utilization in the Covid-19 vaccine drive. The proposed novel micro cold storage aims to be silent, clean, mobile, without moving parts, and reliable for the last-mile vaccine logistics as a vaccine carrier to the remote rural areas. This paper deals with the novel design, development, and experimental investigation of solar photovoltaic powered thermoelectric-based micro cold storage as a Covid-19 vaccine carrier for rural areas. The design consideration of Covid-19 vaccine storage has been reported. The experimental results ensure the World Health Organization recommended vaccine storage (i.e., vaccine carrier) temperature range of +2 to +8 °C. Therefore, green energy and refrigeration system provide environmental sustainability by mitigating 700kg of annual carbon emission.

Background All currently available products for diagnosis and therapy of type I allergies are protein extracts from allergenic source material. The extracted proteins have different properties and their structure is differently labile to temperature variations. Despite various pharmaceutical formulations to increase product stability, with few exceptions, allergen products must be refrigerated to ensure that their quality and native protein structure do not change during storage and transport. Maintaining quality is a challenge in complex distribution chains. Methods Regulatory requirements and guidelines that apply to cold storage and transport of allergen products are summarized and the responsibilities of the stakeholders are explained. Results The storage conditions determined in stability studies correspond to the transport conditions. These stability data can also be used to assess tolerable conditions during transport. According to a good distribution practice (GDP) contracts must be concluded between the responsible pharmaceutical entrepreneur and the qualified distribution service provider that regulate storage and transport in accordance with the product requirements. Conclusion Monitoring of storage and transport conditions is achieved by transport in qualified means of transport (e.g. truck). Alternatively, qualified transport packaging with active or passive cooling (e.g. cold packs) and qualified “data loggers” that record the transport temperatures can be used. Regardless of the system used, it must be demonstrated—by validating the transport conditions, routes and packaging at different times of the year and over the entire duration of transport—that regulatory requirements are met and that the quality of the products is maintained during shipment.

In this work, a phase change material (PCM)-based prototype solar cold storage (PSCS) system was developed to investigate the effect of shelf life of fresh post-harvested ripening mango and the per...

OBJECTIVE: The aim of this study was to evaluate peak serum alanine aminotransferase (ALT) and postoperative clinical outcomes after hypothermic oxygenated machine perfusion (HOPE) versus static cold storage (SCS) in extended criteria donation (ECD) liver transplantation (LT) from donation after brain death (DBD).BACKGROUND: HOPE might improve outcomes in LT, particularly in high-risk settings such as ECD organs after DBD, but this hypothesis has not yet been tested in a randomized controlled clinical trial (RCT).METHODS: Between September 2017 and September 2020, 46 patients undergoing ECD-DBD LT from four centers were randomly assigned to HOPE (n = 23) or SCS (n = 23). Peak-ALT levels within 7 days following LT constituted the primary endpoint. Secondary endpoints included incidence of postoperative complications [Clavien-Dindo classification (CD), Comprehensive Complication Index (CCI)], length of intensive care- (ICU) and hospital-stay, and incidence of early allograft dysfunction (EAD).RESULTS: Demographics were equally distributed between both groups [donor age: 72 (IQR: 59-78) years, recipient age: 62 (IQR: 55-65) years, labMELD: 15 (IQR: 9-25), 38 male and 8 female recipients]. HOPE resulted in a 47% decrease in serum peak ALT [418 (IQR: 221-828) vs 796 (IQR: 477-1195) IU/L, P = 0.030], a significant reduction in 90-day complications [44% vs 74% CD grade ≥3, P = 0.036; 32 (IQR: 12-56) vs 52 (IQR: 35-98) CCI, P = 0.021], and shorter ICU- and hospital-stays [5 (IQR: 4-8) vs 8 (IQR: 5-18) days, P = 0.045; 20 (IQR: 16-27) vs 36 (IQR: 23-62) days, P = 0.002] compared to SCS. A trend toward reduced EAD was observed for HOPE (17% vs 35%; P = 0.314).CONCLUSION: This multicenter RCT demonstrates that HOPE, in comparison to SCS, significantly reduces early allograft injury and improves post-transplant outcomes in ECD-DBD liver transplantation.

Potato is a national superior vegetable commodity that is prioritized for development by the government. Bener Meriah Regency is a center for potato development, supported by climatic conditions suitable for potato growth. However, so far the production of potato plants has not been able to meet Indonesia's domestic needs. This study aims to describe what technologies are applied by potato farmers in Bener Meriah and want to see how the level of technology adoption applied by potato farmers in Bener Meriah Regency is analyzed descriptively qualitatively, statistically, and using crosstabulation. The results showed that the tolerance attitude of potato farmers who used technology in Bener Meriah Regency was included in the high category, namely daring to take risks and having more than two efforts in overcoming the risks of potato farming. The use of technology that has been applied by potato farmers in Bener Meriah is the technology of using superior seeds, cultivation techniques that have followed the recommendations of the extension worker, the use of vegetable pesticides, pest control according to the instructor's recommendations, the use of mulch, hand tractor, sprayer, irrigation, cold storage technology, and good packaging. Then potato farmers who have a high level of technology adoption are more tolerant in facing farming risks.

Static cold storage has been the gold standard for deceased donor kidney and liver graft preservation. Ex vivo organ perfusion technology has emerged as a potential alternative to static cold storage for kidney and liver graft preservation. Hypothermic machine perfusion of marginal deceased donor kidney grafts has become a standard clinical practice in kidney transplantation. Further studies are required to elucidate the role of normothermic machine perfusion for marginal deceased donor kidney grafts. Multicenter, prospective randomized trials have been initiated in the USA to evaluate application of both hypothermic and normothermic machine perfusion as an alternative to static cold storage for marginal deceased donor liver grafts. Ex vivo organ perfusion technology is in period of widespread growth in the field of liver transplantation. Significant regulatory, logistical, and financial issues need to be addressed before broader clinical application of ex vivo organ perfusion in liver transplantation.

Background After cold storage (CS) and subsequent transplantation, fatty liver is more inclined to develop liver dysfunction and serious postoperative complications in contrast to healthy liver. Hypothermic oxygenated perfusion (HOPE) is a safe and efficacious system, which can repair fatty liver and reduce ischemia-reperfusion injury. The aim of this research is to investigate the function of Brg1/Nrf2/HO-1 signaling pathway in the protective effect of HOPE on ischemia-reperfusion injury of fatty liver. Methods The mouse fatty liver model was successfully established and verified by hematoxylin-eosin (HE) staining and oil red O staining. The animals were divided into Control group, CS group and HOPE group. The levels of liver enzyme and lactate in the perfusate were used to measure liver function and cellular metabolism. HE staining and TUNEL staining were utilized to assess the tissue structure and apoptosis, respectively. The levels of superoxide dismutase, malondialdehyde and reactive oxygen species in liver tissue were measured to quantitatively analyze the degree of oxidative stress, and the expressions of protein Brg1, Nrf2 and HO-1 were detected by means of the western blot. Double-labeling immunofluorescence was to explore the colocalization of Brg1 and Nrf2. Results The injury of the liver in the CS group was more serious than that in the control group. However, HOPE could significantly reduce the injury, which was manifested by the improvement of liver function and cellular metabolism, and the lower degrees of apoptosis, necrosis and oxidative stress. Furthermore, the expressions of Brg1, Nrf2 and HO-1 in the HOPE group were significantly increased than those in the CS group. Conclusions One-hour HOPE treatment before reperfusion can obviously improve the injury of fatty liver in mice. The underlying mechanism may be that the interaction of Brg1 and Nrf2 can selectively activate the transcription of HO-1.

The quality of such processed agrifood products as dehydrated apple is related to the quality and variety offresh harvested products and connected with wastage reduction throughout the agrifood supply chain. Forthis purpose, cold-storage management is important to avoid or mitigate the quality decay of fresh prod-ucts stored in refrigerated systems. This paper explores the benefits of a two-stage stochastic programmingmodel for product quality through the selection of producers and the management of cold storage to miti-gate deterioration and guarantee the maintenance of quality. A case study with real data from an agribusinesscompany is presented in the case study to illustrate and assess the suitability of the stochastic approach. Un-certainty regarding the conversion rate of fresh apples into the final dehydrated product and the purchasecost of the apples in the system are represented through scenarios generated from historical data. Recourseactions include the purchase of additional fruit and renting of additional cold stores to meet the demand.Based on the different scenarios, the value of the stochastic solution shows that modeling and solving theproposed stochastic model minimizes costs by an average of around 6.4%. In addition, the expected valueof perfect information demonstrates that using a proactive strategy could reduce costs by up to 9%. Theseresults ensure the applicability of this model in practice before and during the harvesting season for planningand replanning as uncertainty is revealed under a rolling horizon. The authors wish to acknowledge Marcos Oliva-Fernández for his valuable comments and sugges-tions and CYTED program for supporting the thematic network BigDSS-Agro (P515RT0123).D.Sc. Marcela González-Araya would like thank to FONDECYT Project 1191764 (Chile) forits financial support and D.Sc. Wladimir Soto-Silva would like to thank MEC Project 80180022(Chile). Moreover, this work was supported by the Ministerio de Economía y Competitividad un-der contract TIN2017-84553-C2-2-R and the Ministerio de Ciencia e Innovación under contractPID2020-113614RB-C22. Jordi Mateo and Francesc Solsona are members of the research group2017-SGR363 and Lluís M. Plà of 2017-SGR01193, funded by the Generalitat de Catalunya.Also, this research was partly supported by the European Union FEDER (CAPAP-H5 networkTIN2014-53522-REDT).

Background Pediatric heart transplant (HTx) recipients with congenital heart defects require complex concomitant surgical procedures with the risk of prolonging the allograft’s ischemic time. Ex vivo allograft perfusion with the Organ Care System (OCS; Transmedics, Andover, MA) may improve survival of these challenging patients. Methods In this retrospective, single-center study a consecutive series of 8 children with allografts preserved using the OCS was compared with 13 children after HTx with cold storage of the donor heart from March 2018 to March 2020. Results Median recipient age in the control group was 18 months (range, 1-189) versus 155 months (range, 83-214) in the OCS group, and the baseline differences between the 2 groups were not significant. Fifty percent of the children in the OCS group had complex congenital heart defects (vs 15% of the control subjects). Median operation time during HTx in the OCS group was 616 minutes (range, 270-809) versus 329 minutes (range, 283-617). Because of the time of ex vivo allograft perfusion (265 minutes [range, 202-372]) median total ischemia time was significantly shorter in the OCS group: 78 minutes (range, 52-111) versus 222 minutes (range, 74-326). The incidence of primary graft, renal, or hepatic failure did not differ between the groups. Graft function and the occurrence of any treated rejection at follow-up revealed no significant difference between the 2 groups. One-year survival was 88% in the OCS group (vs 85%). Conclusions Ex vivo allograft perfusion enabled complex pediatric HTx, yielding outcomes as positive as those of children whose donor hearts were stored in ice-cold solution.

District cooling (DC) is gaining interest with global warming and rising demands on indoor comfort. As DC grid expansions are capital intensive, cost effective alternatives to meet these rising cooling demands are desired. Integrating cold storage (CS) into the grids is one attractive choice, allowing peak shaving, load shifting, and renewable electricity recovery via power-to-cold. To analyze the impact of new CSs, the DC distribution grid dynamics must be investigated. This work evaluates the implementation of several new CSs into an existing DC system (called the base case-BC), to find the optimal solution. This is performed considering the case study DC system of Norrenergi AB, Sweden, catering to Solna and Sundbyberg via three production plants Solnaverket, Sundbybergsverket and Frosundaverket, and a 10 MW CS (in Solnaverket). The software tool Netsim is used for distribution grid dynamics analysis of the BC and three scenarios with additional cold storages, for the optimization of differential pressure (dP) of the grids to be within 100–800 kPa. These scenarios include: one additional 15 MW CS in Sundbybergsverket (Scenario 1), one additional 15 MW CS in Frosunda (Scenario 2) and two additional 3 MW CSs in Sundbybergsverket and Frosunda (Scenario 3). The CSs in Sundbybergsverket are centrally placed, whereas, those in Frosunda were positioned in a grid loop experiencing low differential pressure, identified in Netsim simulations of BC. The simulations were done for 24 h at 1-hour resolution, on a chosen historically highest demand day (02 August 2018). The results indicate that the optimal solution is implementing two additional CSs in Sundbybergsverket (centralized) and Frosunda (distributed), each with a capacity between 3–7.5 MW (6–15 MW total capacities). Further evaluations to determine the optimal sizing of these CSs is the next step in this study.

Lung transplantation offers a lifesaving therapy for patients with end-stage lung disease but its availability is presently limited by low organ utilization rates with donor lungs frequently excluded due to unsuitability at assessment. When transplantation does occur, recipients are then vulnerable to primary graft dysfunction (PGD), multitudinous short-term complications, and chronic lung allograft dysfunction. The decision whether to use donor lungs is made rapidly and subjectively with limited information and means many lungs that might have been suitable are lost to the transplant pathway. Compared to static cold storage (SCS), ex vivo lung perfusion (EVLP) offers clinicians unrivalled opportunity for rigorous objective assessment of donor lungs in conditions replicating normal physiology, thus allowing for better informed decision-making in suitability assessments. EVLP additionally offers a platform for the delivery of intravascular or intrabronchial therapies to metabolically active tissue aiming to treat existing lung injuries. In the future, EVLP may be employed to provide a pre-transplant environment optimized to prevent negative outcomes such as primary graft dysfunction (PGD) or rejection post-transplant.

The application of perfluorocarbons, which can carry large quantities of oxygen, in organ preservation was limited by their poor solubility in water. A stable form of perfluorocarbon dispersed in suitable buffers is urgently needed. Perfluorocarbon emulsion was designed and characterized with respect to size distribution, rheology, stability, and oxygen-carrying capacity. The state of DCD rat donor livers preserved by the oxygenated perfluorocarbon emulsion was studied after ex vivo reperfusion by using biochemistry, pathology, and immunohistochemistry methods. Perfluorocarbon emulsion was successfully prepared by high-pressure homogenization. Optimized perfluorocarbon emulsion showed nanoscale size distribution, good stability, and higher oxygen loading capacity than that of HTK solution or water. The state of preserved livers after cardiac death rat liver was improved significantly after static cold storage for 48 hours in this oxygenated perfluorocarbon emulsion. The ATP content and down-regulation of HIF-1a expression after preservation of the liver graft by the oxygenated perfluorocarbon emulsion suggested the advantage of adequate oxygen supply for adequate time. This perfluorocarbon emulsion reported here might be considered a promising system for oxygenated donor liver storage by attenuation of hypoxia.

The main objective of static cold storage is to reduce cellular metabolic demands to extend the period of ischaemia prior to transplantation. Hypothermia does not halt metabolism and the absence of oxygen causes a cellular shift toward anaerobic respiratory pathways. There is emerging evidence that the introduction of oxygenation during organ preservation may help ameliorate the degree of ischaemia reperfusion injury and improve post-transplantation outcomes. This review aims to appraise and summarise all published literature that utilises oxygenation to improve kidney preservation for purposes of transplantation. We performed a scoping review of the literature using the bibliographic databases Embase and MEDLINE. The final date for searches was 20 March 2021. All research studies included were those that reported oxygen delivery during kidney preservation as well as providing a description of the oxygenation technique. 17 human and 48 animal studies met the inclusion criteria. The oxygen delivery methods investigated included hypothermic oxygenated machine perfusion (HOPE), oxygen carriers, two-layer method, venous systemic persufflation, hyperbaric oxygenation, normothermic machine perfusion and sub-normothermic machine perfusion. The COMPARE trial was the only study carried out with the most methodological robustness being a randomised, double blind, controlled, phase III trial that investigated the efficacy of HOPE versus HMP. A variety of studies reflect the evolution of oxygenation with useful lessons and encouraging outcomes. The first in human studies investigating HOPE and oxygen carriers are most robustly investigated strategies for oxygenation during kidney preservation and are, therefore, the best clinical references.

Background Ischemia-reperfusion injury (IRI) is the major cause of delayed graft function (DGF) during the post-transplantation period. Estradiol (E2) prevents IRI-induced kidney dysfunction and tissue injury. However, many side-effects limit E2's in vivo application. Recent evidence uncovers E2's expanded use in the field of transplantation. We aimed to study if and how E2 exerts protective activity during the period of kidney organ preservation. Methods The autologous kidney transplant model in rats was first established. Rats were divided into 5 groups, which were normal group (N), sham group (Sham), static cold storage (SCS) 4 h group (Control), SCS 4 h + ethanol (1 µl/mL) group (Solvent), and SCS 4 h + ethanol (1 µl/mL) + E2 (1000 ng/mL) group (E2). ERα expression under hypothermia was measured by western blotting. Moreover, biochemical analysis of plasma levels of Creatinine, BUN, Estradiol, and testosterone were examined. Among all groups, kidney tissues were collected and processed for further western blot analysis about ERα, eNOS, Bcl-2, and Bax expression, histological analyses such as H&E staining to evaluate pathological severity. In addition, a TUNEL assay is performed to evaluate apoptosis. Results E2 co-preservation up-regulated ERα expression under hypothermia. Moreover, E2 co-preservation reduced levels of Creatinine and BUN in plasma but without affecting estradiol and testosterone. Further, E2 co-preservation increased expression of eNOS and anti-apoptotic Bcl-2, and decreases expression of pro-apoptotic Bax. E2 co-preservation significantly inhibited IRI-induced apoptosis and evidently improved pathological severity in the kidney of rats. Conclusions E2 co-preservation exerts protective activity against IRI-induced pro-inflammatory and pro-apoptotic effects in kidneys during organ preservation time and improves transplanted kidney function.

Background: Consumers’ lifestyles demand high-quality products, requesting adequate fruit storage. Management of ethylene production is of paramount importance when planning postharvest storage, since this phytohormone is the key molecule behind the ripening and senescence process. Cold storage combined with 1-MCP has been one of the most applied postharvest treatments to extend the shelf-life of several fruit. However, 1-MCP is a potent inhibitor of ethylene action, leading frequently to the blockage of ripening denominated as ‘evergreen’ effect. Scope and approach: Ethylene biosynthesis and perception pathway are described, as well as a critical review on 1-MCP inhibitory mechanisms. Technologies used to induce postharvest ripening after 1-MCP application are described with special attention to the latest and most significant published works. The most relevant 1-MCP reversion strategies are discussed, aiming to develop more innovative and effective approaches for stimulating ripening. Finally, the importance of tailoring treatments to specific cultivars is discussed, using pear as a case study. Key findings and conclusions: Optimizing temperature and applying exogenous ethylene have been the main methods to reverse the effect of 1-MCP. Also, treatment with other phytohormones has shown promising results. However, the strategies effectiveness is dependent on the cultivar, time of application, and concentration of the applied compound. Also, since 1-MCP binds irreversibly to the ethylene receptor, the biosynthesis of new receptors may reverse the ‘evergreen’ behaviour. Therefore, attempts should be made to develop strategies according to each cultivar and their capacity to stimulate the expression of ethylene genes both related to its biosynthesis and perception. info:eu-repo/semantics/publishedVersion

Tracing the vaccines from the manufacturing labs till the health centers administering doses to child is a cumbersome process with the involvement of large number of stakeholders and with multiple levels of book-keeping mechanisms. This work primarily focuses on the problem of traceability of immunization vaccines from manufacturing facility, through the distribution mechanisms in cold storage network and the vaccine handling/administration facilities, till the end consumer in the Indian context. The proposed research named, Immunochain is a state-of-the-art big data and blockchain technologies powered, mobile/web-enabled vaccine traceability solution for immunization programs in India. It is vendor neutral, scalable, replicable, and reusable across different immunization programs in any geographical context. Experiments and pilot testing on Indian geography indicates that the proposed approach outperforms some of the existing approaches in vaccine traceability and record management systems.

Background After the revised organ transplant law came into effect in Japan, donations of organs under brain death have been increasing; however, because of the expansion of donor indications, donations from expanded criteria donors and cardiac arrest donors (donation after cardiac death) have also increased. In kidney transplantation, ischemia-reperfusion injury results in a high rate of delayed graft function, which adversely affects patients’ long-term prognoses. Hypothermic machine perfusion preservation results in superior postoperative function and survival rates compared with cold storage preservation. We used an organ preservation device for kidneys and performed a graft viability evaluation before to kidney transplantation. Methods We used the CMP-X08 perfusion device (Chuo-Seiko Co, Ltd, Asahikawa, Hokkaido, Japan) and Belzer MPS solution to preserve the donated organ. The perfusion pressure and temperature were monitored during cold storage with continuous perfusion. Standard renal transplantation protocols were followed. A renal biopsy was performed 1 hour after transplantation and the renal function was evaluated. This study followed the principles of the Declaration of Helsinki. Results The first presented case is of a 63-year-old woman who received a kidney from a middle-aged man with brain death due to hypoxic encephalopathy. The creatinine at the time of admission was 0.9 mg/dL and at the time of excision was 2.86 mg/dL. The total perfusion time was 120 minutes. The total ischemia time was 7 hours and 15 minutes. The recipient urinated 115 minutes postoperatively, and no dialysis was required. The second presented case is of a 47-year-old man with a 15-year history of dialysis who received a kidney from a middle-aged woman with brain death due to subarachnoid hemorrhage. The creatinine at the time of admission was 0.8 mg/dL and at the time of excision was 0.77 mg/dL. The total perfusion time was 240 minutes. The total ischemia time was 13 hours and 14 minutes. The recipient urinated 38 minutes postoperatively, and no dialysis was required. Conclusions Mechanical perfusion storage performed for 2 to 4 hours resulted in a viable organ that was successfully transplanted in both cases.

The paper presents the methodology of the analysis of the cooling system reconstruction in a food cold store under the regulations applicable from the beginning of 2020. They result from the so-called the F-Gas Act concerns the use of refrigerants with a low environmental impact. First, the elements of the existing regulations on the use of refrigerants were discussed. This part of article focus mainly on the F-Gas Act and the regulations it entails. Then, the refrigerants used so far in refrigeration systems were compared with substitutes, which were the only ones that have been approved for use since 2020, thanks to the low GWP index. Their properties are briefly described, along with the benefits (primarily for the environment) of their use. The main part of the work is the analysis of the reconstruction of the cooling system to use an alternative refrigerant. During the work, the construction of the cold storage was analyzed together with the system currently working in analysed location. Then, the heat balance was calculated, thanks to which it was possible to determine the demand for cold. Than, several refrigerants that meet the latest standards and application regulations were selected. Their operating parameters were examined, the possible variants of use were compared in relation to the determined demand for cooling and the most important operational features were summarized.

Background Normothermic ex situ liver perfusion (NEsLP) reduces reperfusion injury of donation after circulatory death (DCD) grafts and optimizes graft function. The goal of our study was to elucidate how NEsLP impacts global metabolism in DCD grafts using high-throughput metabolomics. Methods Pig livers were preserved by two different techniques: static cold storage (SCS) and normothermic ex-situ liver perfusion (NEsLP). Grafts obtained from heart-beating donors (HBD) were compared to donation after circulatory death (DCD) grafts with either 30 minutes (DCD30) or 60 minutes (DCD60) ischemia time. Liver tissues were collected at the end of preservation period (T0) with either cold storage or NEsLP (n=5 per group). Grafts were transplanted into recipient pigs and a second liver biopsy was collected 2 hours following liver transplantation (T1). Snap-frozen tissue was processed and analyzed by Sciex 6600 Q-TOF high resolution mass spectrometer. Data analysis was performed using MetaboAnalyst 4.0 software. Results Prolonged ischemia resulted in 38 out of 81 metabolites being differentially abundant over time. Mitochondrial metabolism was significantly affected, with disruption in oxidative phosphorylation capacity i.e the Warburg effect (p= 3.62E-03) and urea cycle (p=7.95E-0.4). NEsLP resulted in improved mitochondrial metabolism and glycolysis (4.20E-02) oxidation of branched chain fatty acids (p=4.07E-02). Conclusion This unbiased, high-throughput metabolomics study reveals that mitochondrial function is globally rescued with NEsLP, associated with improvement in DCD graft function. NEsLP is able to rescue DCD grafts, improving their metabolic function to that of livers not exposed to DCD procurement.

There is nothing of higher value than human life. A close second is a human tissue that is utilized to help prolong that human life. Proper storage and management of the environment in which these materials are being stored are critical. A common practice in monitoring cold chain conditions for these temperature-sensitive materials is to employ a physical, thermal buffer into which the temperature probe is inserted. This buffer maybe a bottle of glycol or other liquid, a container of glass beads, an aluminum block, or nearly any other media the user feels is appropriate. The purpose of the buffer is to simulate the stored product’s experience rather than the air temperature. This will not be accomplished if the physical buffer is not matched to the stored product’s thermal properties and its container. Cold chain managers are faced with a complex problem if they attempt to take this issue into account. Furthermore, a match is impossible with a single physical buffer when the cold storage unit contains different products and various container sizes. This paper addresses the results of this mismatch from multiple factors and brings to the forefront the real-world problems that may result. Additionally, this paper will discuss a demonstrated solution that will accurately represent the stored materials, no matter the packaging size, material, or contents.

Background Heart transplantation from controlled donation after the circulatory determination of death (cDCDD) may be an option to increase the pool of grafts for transplantation. Materials and methods Initial experiences on cDCDD heart transplantation were based on the direct procurement of the heart followed by preservation with ex situ perfusion devices. Later, the use of thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as an option to recover hearts. We present a case of a heart transplant using a graft from controlled donation after circulatory death. Cardiac preservation was performed by postmortem TA-NRP followed by cold storage. Ex situ perfusion device was not used. Discussion and conclusion This is one of the first published cases of a controlled donation after circulatory death heart retrieved using only TA-NRP and successfully transplanted.

PurposeAgricultural aggregation schemes provide numerous farmer-facing benefits, including reduced transportation costs and improved access to higher-demand urban markets. However, whether aggregation schemes also have positive food security dimensions for consumers dependent on peri-urban and local markets in developing country contexts is currently unknown. This paper aims to narrow this knowledge gap by exploring the actors, governance structures and physical infrastructures of the horticultural value chain of Bihar, India, to identify barriers to using aggregation to improve the distribution of fruits and vegetables to more local market environments.Design/methodology/approachThis study uses mixed methods. Quantitative analysis of market transaction data explores the development of aggregation supply pathways over space and time. In turn, semi-structured interviews with value chain actors uncover the interactions and decision-making processes with implications for equitable fruit and vegetable delivery.FindingsWhilst aggregation successfully generates multiple producer-facing benefits, the supply pathways tend to cluster around urban export-oriented hubs, owing to the presence of high-capacity traders, large consumer bases and traditional power dynamics. Various barriers across the wider enabling environment must be overcome to unlock the potential for aggregation to increase local fruit and vegetable delivery, including informal governance structures, cold storage gaps and underdeveloped transport infrastructures.Originality/valueTo the best of the authors’ knowledge, this study is the first critical analysis of horticultural aggregation through a consumer-sensitive lens. The policy-relevant lessons are pertinent to the equitable and sustainable development of horticultural systems both in Bihar and in similar low- and middle-income settings.

Aberrant complement activation leads to tissue damage during kidney transplantation, and it is recognized as an important target for therapeutic intervention. However, it is not clear whether cold storage (CS) triggers the complement pathway in transplanted kidneys. The goal of the present study was to determine the impact of CS on complement activation in renal transplants. Male Lewis and Fischer rats were used, and donor rat kidneys were exposed to 4 h or 18 h of CS followed by transplantation (CS + transplant). To study CS-induced effects, a group with no CS was included in which the kidney was removed and transplanted back to the same rat [autotransplantation (ATx)]. Complement proteins (C3 and C5b-9) were evaluated with Western blot analysis (reducing and nonreducing conditions) and immunostaining. Western blot analysis of renal extracts or serum indicated that the levels of C3 and C5b-9 increased after CS + transplant compared with ATx. Quite strikingly, intracellular C3 was profoundly elevated within renal tubules after CS + transplant but was absent in sham or ATx groups, which showed only extratubular C3. Similarly, C5b-9 immunofluorescence staining of renal sections showed an increase in C5b-9 deposits in kidneys after CS + transplant. Real-time PCR (SYBR green) showed increased expression of CD11b and CD11c, components of complement receptors 3 and 4, respectively, as well as inflammatory markers such as TNF-α. In addition, recombinant TNF-α significantly increased C3 levels in renal cells. Collectively, these results demonstrate that CS mediates aberrant activation of the complement system in renal grafts following transplantation. NEW & NOTEWORTHY This study highlights cold storage-mediated aberrant activation of complement components in renal allografts following transplantation. Specifically, the results demonstrate, for the first time, that cold storage functions in exacerbation of C5b-9, a terminal cytolytic membrane attack complex, in renal grafts following transplantation. In addition, the results indicated that cold storage induces local C3 biogenesis in renal proximal cells/tubules and that TNF-α promotes C3 biogenesis and activation in renal proximal tubular cells.

Background Given the susceptibility of organs to ischaemic injury, alternative preservation methods to static cold storage (SCS), such as normothermic machine perfusion (NMP) are emerging. The aim of this study was to perform a comparison between NMP and SCS in liver transplantation with particular attention to bile duct lesions. Methods The outcomes of 59 consecutive NMP-preserved donor livers were compared in a 1 : 1 propensity score-matched fashion to SCS control livers. Postoperative complications, patient survival, graft survival and bile duct lesions were analysed. Results While patients were matched for cold ischaemia time, the total preservation time was significantly longer in the NMP group (21 h versus 7 h, P Conclusion The use of NMP allowed for a significantly prolonged organ preservation with a lower rate of observed ischaemic-type bile duct lesions.

BACKGROUND Familial pseudohyperkalemia (FP) is characterized by an increased rate of potassium leakage in refrigerated red cells and is associated with the minor allele of the single nucleotide polymorphism rs148211042 (R723Q) in the ABCB6 gene. The study aims were to obtain the minor allele frequencies of ABCB6 variants and to measure supernatant potassium accumulation, and other red cell storage parameters, in red cell concentrates (RCC) from carriers of variant rs148211042 under standard blood bank conditions. STUDY DESIGN Whole blood units were collected from 6 FP individuals and 11 controls and processed into RCC in additive solution. RCC were sampled and tested over cold storage for full blood count, extracellular potassium, glucose, lactate, microvesicle release, deformability, hemolysis, pH, adenosine triphosphate, and 2,3-diphosphoglycerate. RESULTS Screening of genotyped cohorts identified that variant rs148211042 is present in 1 in 394 British citizens of European ancestry. FP RCC had significantly higher supernatant potassium at all time points from day 3 onwards (p

Background Influenza vaccination is uncommon in low-resource settings. We evaluated aspects of operational feasibility of influenza vaccination programs targeting risk groups in the World Health Organization (WHO) African (AFR) and South-East Asian (SEAR) Regions. Methods We estimated routine immunization and influenza vaccination campaign doses, doses per vaccinator, and cold storage requirements for 1 simulated country in each region using evidence-based population distribution, vaccination schedule, and vaccine volumes. Influenza vaccination targeted persons, We investigated the operational feasibility of preseasonal influenza vaccination campaigns in countries in World Health Organization (WHO) African and South-East Asian Regions. Influenza vaccination campaigns targeting most risk groups substantially increase doses and doses per vaccinator over routine immunization baselines.

Organ shortage and the increasing use of extended criteria donor grafts for transplantation drives efforts for more efficient organ preservation strategies from simple cold storage toward dynamic organ reconditioning. The choice of a suitable preservation solution is of high relevance in different organ preservation or reconditioning situations. Custodiol-MP is a new machine perfusion solution giving the opportunity to add colloids according to organ requirements. The present study aimed to compare new Custodiol-MP with clinically established Belzer MPS solution. Porcine kidneys were ischemically predamaged and cold stored for 20 hours. Ex vivo machine reconditioning was performed either with Custodiol-MP (n = 6) or with Belzer MPS solution (n = 6) for 90 minutes with controlled oxygenated rewarming up to 20°C. Kidney function was evaluated using an established ex vivo reperfusion model. In this experimental setting, differences between both types of perfusion solutions could not be observed. Machine perfusion with Custodiol-MP resulted in higher creatinine clearance (7.4 ± 8.6 mL/min vs. 2.8 ± 2.5 mL/min) and less TNC perfusate levels (0.22 ± 0.25 ng/mL vs. 0.09 ± 0.08 ng/mL), although differences did not reach significance. For short-term kidney perfusion Custodiol-MP is safe and applicable. Particularly, the unique feature of flexible colloid supplementation makes the solution attractive in specific experimental and clinical settings.

To compare ex vivo results of donor corneas maintained in Sinasol with those stored in Optisol-GS and reporting clinical outcomes of grafted Sinasol-versus Optisol-GS-stored corneas. In phase I, paired donor corneas were maintained in Sinasol or Optisol-GS. Afterward, the corneas were subjected to slit-lamp biomicroscopic and specular microscopic examinations on days 1 and 7, and then to trypan blue staining on day 7. The same examinations were performed on the corneas that were kept in Sinasol or Optisol-GS for 14 days. In phase II, the post-operative reports of 72 consecutive corneal transplantations were recorded using Sinasol- or Optisol-GS-preserved corneas. In phase I, 128 corneas from 64 donors and 59 corneas from 33 donors were investigated for 7 and 14 days, respectively. The EC indices were comparable between the groups at the measurement periods. The EC losses over 7 and 14 days were 3.7% and 19.9% in Sinasol against 4.6% and 20.8% in Optisol-GS. Although fair quality corneas were more common in Optisol-GS group after 7 (P = 0.04) and 14 days (P = 0.034), changes of stromal edema, Descemet's fold, and other quality ratings during 14 days were not different between the groups. In phase II, all the transplanted corneas were postoperatively clear with no adverse reactions. The overall results indicate that Sinasol is a safe, effective, and affordable intermediate cold storage medium for preservation of corneas.

Although machine perfusion is a hot topic today, we are just at the beginning of understanding the underlying mechanisms of protection. Recently, the first randomized controlled trial reported a significant reduction of ischemic cholangiopathies after transplantation of livers donated after circulatory death, provided the grafts were treated with an endischemic hypothermic oxygenated perfusion (HOPE). This approach has been known for more than fifty years, and was initially mainly used to preserve kidneys before implantation. Today there is an increasing interest in this and other dynamic preservation technologies and various centers have tested different approaches in clinical trials and cohort studies. Based on this, there is a need for uniform perfusion settings (perfusion route and duration), and the development of general guidelines regarding the duration of cold storage in context of the overall donor risk is also required to better compare various trial results. This article will highlight how cold perfusion protects organs mechanistically, and target such technical challenges with the perfusion setting. Finally, the options for viability testing during hypothermic perfusion will be discussed.

In 2013, a clinical trial was initiated to investigate cell therapy for the treatment of corneal endothelial decompensation. Cultivating human corneal endothelial cells (CECs) while maintaining their functional phenotype is challenging; therefore, establishment of a confirmed protocol is pivotal for obtaining approval from regulatory authorities for use of cellular therapy products. In this study, we evaluated organ culture (OC) as a storage method for donor corneas used as a raw material for establishing CEC cultures. OC allows storage of corneal tissue for conventional corneal transplantation at 31-37 °C for up to 5 weeks, whereas storage at 4 °C is limited to 2 weeks. We investigated 20 pairs of corneas: one cornea of each pair was stored in OC and the other in cold storage for one week before CEC culture. In 15/20 cases, the CECs assumed a hexagonal sheet-like monolayer structure and expressed endothelial function-related markers. CECs were also obtained from OC corneas that had been stored for 1 (n = 19) and 2 (n = 7) months. As a further test, CECs were cultivated from 5 OC corneas that had been transported from France to Japan. In all cases, these corneas, even after international transport, generated CECs that formed hexagonal monolayers with clinically applicable and sufficiently high cell densities. In conclusion, the CEC cultures required for endothelial cell therapy can be obtained from OC corneas without changing the standard storage operating procedures of the eye banks.

A distributed integrated cooling system, including cold supply and cold storage, can store cold energy during the valley electricity period and release cold energy during peak electricity period, thus effectively realizing cutting peak electricity loads can achieve higher economic performance and capacity factors. However, a distributed integrated cooling system’s planning suffers from lacking systematic guidance in planning and optimal operation. This paper presented an efficient analytical planning method considering cutting peak electricity power and the corresponding compensating cost and inducted the condition of applying an integrated cooling system. The critical operating electricity price and economic equilibrium electricity price are presented as two indexes to evaluate the economic condition of operating and constructing an integrated cooling system. The analytical planning model is validated to be exact and efficient by the numerical simulation due to less iteration. The planning results show that a distributed integrated cooling system is fully utilized during a year, but the relative ability to cut peak electricity load decreases with electrical loads. Because the compensating cost is lower than the price differences between peak and flat-peak electricity prices, which is cheaper than a battery, a distributed integrated cooling system is a cost-effective technology for cutting peak electricity loads.

Delayed graft function (DGF) adversely affects graft survival and function. Machine perfusion (MP) improves DGF rate and may compensate for extended storage time.In this single-center cohort study, we included 193 consecutive kidney transplantations. MP was used in 78 kidneys (36%) and static cold storage (CS) in 115 kidneys (64%). CS kidneys were transplanted first followed by MP kidneys if stored differently. Pairs of kidneys from the same donor were subjected for subgroup analysis and included 58 pairs. The primary endpoints were the rate of DGF and 1- and 5-year graft survival. The secondary endpoints were the rate of the primary nonfunction, mortality, acute rejection, duration of DGF, and 5-year estimated glomerular filtration rate.Median cold ischemia time (CIT) was significantly different between the MP and CS groups (24 vs 20 hours, P .05). MP significantly reduced the rate of DGF (MP vs CS: 21.8% vs 42.6%, P .05, odds ratio 0.34, 95% confidence interval 0.17-0.67) with no impact on overall 1- and 5-year survival rates. Storage method did not affect the duration of DGF, mortality rate, acute rejection, or the 5-year estimated glomerular filtration rate.Hypothermic pulsatile MP significantly reduced the rate of DGF in kidneys transplanted with CIT equal to or longer than 12 hours. It is safe and may compensate for longer storage time.

Pulau Morotai Regency is one of the areas identified by the government as a fisheries-focused Special Economic Zone. However, the reality on the ground is that the fishing industry has only one cold storage facility. One of the factors is the region's remote position, which requires a considerable amount of capital and operational expenditure. Lower energy costs are one way to reduce the operating cost. This study aims to determine the value of each energy-efficient criterion and to know the most efficient energy composition implemented for Cold Storage in Morotai. This study uses the decision matrix approach to compare the operating costs of cold storage with a capacity of 200 tons over 20 years with three possible alternatives: PLN electricity, hybrid electricity (PLN + photovoltaic), and fully photovoltaic energy. With a score of 38 in the decision matrix table, the outcome of the decision matrix calculation indicates that cold storage with a photovoltaic system is much superior.

Cold storage preservation is the standard approach for heart transplantation but is a time-limited method of care. Ex vivo heart perfusion expands the donor pool due by mitigating time and distance barriers and allows the possibility to improve graft function. We report long term follow up of a successful heart transplantation following an ex vivo time of 17 h using the Organ Care System in a patient with a left ventricular assist device.

Extracellular vesicles (EV) that are derived from endothelial progenitor cells (EPC) have been determined to be a novel therapy for acute myocardial infarction, with a promise for immediate “off-the-shelf” delivery. Early experience suggests delivery of EVs from allogeneic sources is safe. Yet, clinical translation of this therapy requires assurances of both EV stability following cryopreservation and absence of an adverse immunologic response to EVs from allogeneic donors. Thus, more bioactivity studies on allogeneic EVs after cold storage are necessary to establish quality standards for its widespread clinical use. Thus, in this study, we aimed to demonstrate the safety and efficacy in delivering cryopreserved EVs in allogeneic recipients as a therapy for acute myocardial infarction. In this present study, we have analyzed the cardioprotective effects of allogeneic EPC-derived EVs after storage at −80°C for 2 months, using a shear-thinning gel (STG) as an in vivo delivery vehicle. EV size, proteome, and nucleic acid cargo were observed to remain steady through extended cryopreservation via nanoparticle tracking analysis, mass spectrometry, and nanodrop analysis, respectively. Fresh and previously frozen EVs in STG were delivered intramyocardially in a rat model of myocardial infarction (MI), with both showing improvements in contractility, angiogenesis, and scar thickness in comparison to phosphate-buffered saline (PBS) and STG controls at 4 weeks post-MI. Pathologic analyses and flow cytometry revealed minimal inflammatory and immune upregulation upon exposure of tissue to EVs pooled from allogeneic donor cells. Allogeneic EPC-EVs have been known to elicit minimal immune activity and retain therapeutic efficacy after at least 2 months of cryopreservation in a post-MI model.

In light of the present evidence, machine perfusion is opening up new horizons in the field of liver transplantation. Although many advances have been made in liver transplantation, organ preservation methods have so far changed very little. Static cold storage is universally used for graft preservation in liver transplantation; however, there is a need for better preservation methods, such as ex vivo machine perfusion, to improve the outcomes by decreasing warm ischemic damage. Based on the findings of basic and clinical trials, hypothermic and normothermic machine perfusion techniques are now commercially available and include the OrganOx metra, Liver Assist, Cleveland NMP device, Organ Care System, and LifePort Liver. Recent clinical trials have provided further evidence for the potential role of normothermic machine perfusion to resuscitate and subsequently improve utilization of marginal or currently discarded livers. Further studies are required to explore the longer-term outcomes, late biliary complications, outcomes in specific high-risk groups, viability biomarkers, optimum and maximum perfusion duration, perfusate composition, and liver-directed therapeutic interventions during normothermic machine perfusion. The use of organs from marginal donors after brain death, such as fatty livers and the livers from elderly donors with multiple comorbidities, may be accepted for machine perfusion in Japan in the near future.

The use of cold preservation solutions to rapidly flush and cool the kidney followed by static cold storage in ice has been the standard kidney preservation technique for the last 50 y. Nonetheless, changing donor demographics that include organs from extended criteria donors and donation after circulatory death donors have led to the adoption of more diverse techniques of preservation. Comparison of hypothermic machine perfusion and static cold storage techniques for deceased donor kidneys has long been debated and is still contested by some. The recent modification of hypothermic machine perfusion techniques with the addition of oxygen or perfusion at subnormothermic or near-normothermic temperatures are promising strategies that are emerging in clinical practice. In addition, the use of normothermic regional perfusion to resuscitate abdominal organs of donation after circulatory death donors in situ before cold flushing is also increasingly being utilized. This review provides a synopsis of the different types of preservation techniques including their mechanistic effects and the outcome of their application in clinical practice for different types of donor kidney.

The possible reno-protective effect of a controlled brief heat-shock treatment during isolated ex vivo machine perfusion of donor grafts prior to reperfusion should be investigated in a primary in vitro study. Porcine kidneys (n = 14) were retrieved after 20 minutes of cardiac standstill of the donor and subjected to 20 hours of static cold storage in University of Wisconsin solution. Prior to reperfusion, kidneys were subjected to 2 hours of reconditioning machine perfusion with gradual increase in perfusion temperature up to 35°C. In half of the kidneys (n = 7), a brief hyperthermic impulse (10 minutes perfusion at 42°C) was implemented in the machine perfusion period. Functional recovery of the grafts was observed upon normothermic reperfusion in vitro. Hyperthermic treatment resulted in a 50% increase of heat shock protein (HSP) 70 and HSP 27 mRNA and was accompanied by ~ 50% improvement of tubular re-absorption of sodium and glucose upon reperfusion, compared with the controls. Furthermore, renal loss of aspartate aminotransferase was significantly reduced to one-third of the controls as was urinary protein loss, evaluated by the albumin to creatinine ratio. It is concluded that ex vivo heat-shock treatment seems to be an easily implementable and promising option to enhance renal self-defense machinery against reperfusion injury after preservation that merits further investigation in preclinical models. CA Minor