Experimental renal preservation by normothermic resuscitation perfusion with autologous blood

Abstract

NP with oxygenated blood was able to restore depleted ATP levels and reverse some of the deleterious effects of CS.

A Pilot Study Assessing the Feasibility of a Short Period of Normothermic Preservation in an Experimental Model of Non Heart Beating Donor Kidneys

“…** P value < 0.05 between end time point and pre-perfusion biopsies within each group. viability [6,18,19]. The small number of animals and predetermined level of ischemic injury in this study did not allow us to directly address organ assessment; however the perfusion parameters measured during NP clearly demonstrated the extent of the warm and cold ischemic injury and are consistent with similar findings in our ex vivo experiments [6,19].…”

“…This was designed using paediatric cardiopulmonary bypass technology (Medtronic, Watford, UK) ( Fig. 1) [6][7][8]. The circuit was primed with the perfusate solution followed by autologous whole blood, which was depleted of leukocytes using a white cell filter (LeukoGuard RS; Pall Medical, Portsmouth, UK) ( Table 1) to give a total circulating volume of approximately 500 mL.…”

“…Preliminary ex vivo studies using clinical grade equipment and 2 h of normothermic perfusion with autologous blood in our laboratory demonstrated that it was possible to resuscitate ATP levels and reverse some of the deleterious effects of cold storage in porcine kidneys in a model of the NHB donor [6].…”

Normothermic Versus Hypothermic Ex Vivo Flush Using a Novel Phosphate-Free Preservation Solution (AQIX) in Porcine Kidneys

“…Others have modified the preservation solution with substrates that promote ATP regeneration, such as inorganic phosphate [24] and histidine-lactobionate-raffinose-based solution [25]. It is clear from the results presented here that a period of normothermic machine preservation using autologous blood has potential for the resuscitation of high energy phosphate metabolites in ischemically damaged kidneys [26].…”

New Strategies and Concepts in Organ Preservation

“…In the kidney, 16 h of cold storage and a subsequent 2 h of NMP showed results inferior to those with 18 h of HMP [72], although both methods produced significantly better results than cold storage alone. In the liver, NMP after 4 h of cold storage failed to resuscitate porcine DCD grafts that had been well preserved when NMP had been installed immediately upon retrieval [22].…”