Which of the following statement(s) is/are true concerning techniques for multiple organ procurement and preservation?

a. The liver and pancreas are generally removed en bloc and separated as a bench procedure

c. UW (University of Wisconsin) cold storage solution is the method of choice of most programs for hepatic and pancreatic transplantation

d. Cardiac allografts have the shortest limit of cold ischemia

The complexity of multiple organ procurement involves the coordination of at least two teams (thoracic and abdominal). The liver and pancreas are generally removed en bloc with the organs separated as a bench procedure, retaining the celiac axis for the liver. The kidneys are also removed en bloc. Studies indicate that post-transplantation renal allograft function is similar regardless of whether simple hypothermia or the more cumbersome technique of machine perfusion are used. For decades, the primary solution used for cold storage preservation of kidneys was EuroCollins solution. Recently, a new solution, UW solution, has been developed with ingredients designed to provide highenergy phosphate precursors, hydrogen ion buffering capacity, and anti-oxidant properties. Although the advantage of this solution over Euro-Collins solution for kidneys is unclear, UW solution is used as the preservation method of choice by nearly all programs performing hepatic and pancreatic transplantations. Both organs can reliably be stored for 24 hours. Kidneys can generally be safely stored for 36 to 48 hours before transplantation. Cardiac preservation has changed relatively little in recent years. Hyperkalemic crystalloid cardioplegia solution is used at 4°C and four hours is generally the accepted limit of cold ischemia. The current limit of cold ischemia for small bowel is approximately 12 hours.