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Transplantation. 2014 Jun 15;97(11):1091-9. doi: 10.1097/TP.0000000000000072.

Mechanisms and consequences of injury and repair in older organ transplants.

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1 Division of Transplant Surgery and Transplant Surgery Research Laboratory, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 2 Division of Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands. 3 Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland. 4 Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 5 Department of Surgery, University Hospital Regensburg, University of Regensburg, Regensburg, Germany. 6 IFB Integrated Research and Treatment Centre Adiposity Diseases, University of Leipzig, Leipzig, Germany. 7 Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL. 8 Address correspondence to: Stefan G. Tullius, M.D., Ph.D., Division of Transplant Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115.


Donor organ scarcity remains a significant clinical challenge in transplantation. Older organs, increasingly utilized to meet the growing demand for donor organs, have been linked to inferior transplant outcomes. Susceptibility to organ injury, reduced repair capacity, and increased immunogenicity are interrelated and impacted by physiological and pathological aging processes. Insights into the underlying mechanisms are needed to develop age-specific interventional strategies with regards to organ preservation, immunosuppression, and allocation. In this overview, we summarize current knowledge of injury and repair mechanisms and the effects of aging relevant to transplantation.

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