The possibility of preserving organs outside the body at two different temperatures, known as cold and normothermic organ preservation has strengthened the potential of expanding donor list and better predicting the outcome. Reactive oxygen species (ROS) production seems to be a very important player in regulating the level of damage in both methods of preservation. The main side effect of cold organ preservation which is known to lead to ischemia reperfusion injury, is highly dependent on ROS production. Thus, warm preservation has recently come to attention. This method is an expensive, sophisticated method which needs large volumes of blood for perfusion of the extracted organ and does not fully inhibit side effects of organ preservation. Thus, implementation of the currently used preservation solutions with established benefits such as UW, with recently found molecules such as hydrogen sulfide or substances which either directly or indirectly increase the levels of this substance by activating cellular pathways such as transsulfuration, could increasingly limit the still damaging properties of preservation. This further prevents delayed organ function or organ rejection due to low organ viability after preservation while increasing organ availability. This simple approach would expand the organ preservation time and help to enhance organ quality for more successful organ transplantation.

hypothermia damage, warm preservation, organ preservation solutions, hydrogen sulfide