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Thomas E. Starzl, MD, PhD; John J. Fung, MD, PhD
JAMA. 1990;263(19):2686-2687. doi:10.1001/jama.1990.03440190142077.
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The three principal struts of transplantation are organ preservation, immunosuppression, and tissue typing. Major pragmatic advances have been made possible by improved static preservation with the University of Wisconsin solution. The safe preservation limits for all organs, but particularly the liver, have been greatly increased since 1987. The most important ingredients of the University of Wisconsin solution are thought to be the impermeants that prevent cell swelling. Two research directions are identifiable in the literature—one, eliminate unneeded constituents of the University of Wisconsin solution, and the other, increase the additives, which already number more than 10.1

The growth of transplantation during the last decade owes much to cyclosporine. The use of cyclosporine with steroids, to which other agents can be added in more or less elaborate cocktails, made possible the transplantation of cadaveric kidneys, livers, hearts, and other organs with an effectiveness scarcely dreamed of 10 years ago. Yet,


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