Hypothermic machine perfusion after static cold storage does not improve the preservation condition in an experimental porcine kidney model

Hosgood, Sarah A.; Mohamed, IH; Bagul, Atul; Nicholson, M. L.

doi:10.1002/bjs.7481

Cited by 33 publications

(25 citation statements)

References 34 publications

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“…8 Accordingly, kidney grafts treated by HOPE showed significant less TLR-4-positive cells, less TNF-a release, less endothelial cell activation after implantation, and were rescued from lethal injury, in contrast to normothermic perfusion or cold storage alone. These results are in contrast to studies using nonoxygenated cold perfusion at relatively high pressure (30 mm Hg) in pigs, 30 but in line with other previous studies on low pressure oxygenated and endischemic cold kidney perfusion. 31,32 The beneficial effects of HOPE were completely lost when oxygen in the perfusate was replaced by nitrogen, pointing to the key function of perfusate oxygen.…”

Section: Discussionsupporting

confidence: 90%

Short, Cool, and Well Oxygenated – HOPE for Kidney Transplantation in a Rodent Model

et al. 2016

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Section: Discussionsupporting

confidence: 90%

Short, Cool, and Well Oxygenated – HOPE for Kidney Transplantation in a Rodent Model

et al. 2016

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“…Hosgood et al [63] did not find any protective effects of end-ischemic HMP on functional recovery during isolated reperfusion of porcine kidneys retrieved after cardiac arrest of the donor. In these experiments, however, machine perfusion was performed without active oxygenation of the perfusate and on grafts that had to some extent suffered warm ischemic injury prior to the start of cold preservation.…”

Section: Hypothermic Reconditioningmentioning

confidence: 99%

New Strategies and Concepts in Organ Preservation

Hoffmann

Minor²

2014

Eur Surg Res

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Organ transplantation is still affected by a notable degree of preservation-associated ischemia and reperfusion injury, which can seriously hamper early graft function. The increasing extension of the criteria for donor organ acceptance, especially for organs that have suffered from periods of warm ischemic injury prior to graft retrieval, results in even higher demands on preserving these ischemia-sensitive grafts. Growing attention is thus directed towards more dynamic preservation methods instead of simple static storage. Particularly in grafts that are retrieved after cardiac standstill of the donor, provision of oxygen to enable some kind of regenerative metabolism appears to be desirable, although the optimal temperature for oxygenated preservation/revitalization is still under debate. Hybrid solutions, comprising conventional cold storage for ease of graft procurement and transportation together with more sophisticated ‘in-house' reconditioning protocols after arrival at the implantation clinic, might help to minimize graft injury during the critical transition from preservation to reperfusion. © 2014 S. Karger AG, Basel

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“…For oxygenation of the perfusate, pure oxygen and carbogen (95% O 2 /5% CO 2 ) have been employed [1,3,6,10,11,12,13,15,16,17]. Since both blood and KHB contain sodium bicarbonate as their buffering agent, which requires CO 2 to exert its function, oxygenation with carbogen seems to offer advantages over pure oxygen [18].…”

Section: Introductionmentioning

confidence: 99%

“…A wide array of perfusates have been employed in IPPK models, including synthetic [7] or Krebs-Henseleit buffer (KHB)-based solutions with albumin as the oncotic agent [8,9]. In order to meet the high oxygen demand and maintenance of oncotic pressure during normothermic reperfusion, blood containing mixtures based on Ringer's solution [10,11,12,13] or KHB [6] have frequently been applied, with reported reperfusion periods of up to 6 h [14]. …”

Section: Introductionmentioning

confidence: 99%

Determination of the Preferred Conditions for the Isolated Perfusion of Porcine Kidneys

Mancina¹,

Kalenski²,

Paschenda³

et al. 2014

Eur Surg Res

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Background: The isolated perfused porcine kidney (IPPK) model has been the method of choice for the early preclinical evaluation of kidney graft preservation techniques. The preferred reperfusion conditions have not yet been determined. Here, we examined the effects of pressure- or flow-controlled perfusion and oxygenation by pure oxygen or carbogen (95% O₂/5% CO₂) on normothermic reperfusion in the IPPK model. Methods: Porcine kidneys were cold-stored for 24 h in histidine-tryptophan-ketoglutarate solution and reperfused for 1 h with normothermic whole blood/Krebs-Henseleit buffer medium (20/80%). Kidneys (n = 5/group) were flow-controlled reperfused with pure oxygen (1 ml/min/g; Flow-O₂) or pressure-controlled reperfused (85 mm Hg mean arterial pressure) and oxygenated with either pure oxygen (Pressure-O₂) or carbogen (Pressure-O₂/CO₂). Renal function and damage were assessed during reperfusion and NGAL and HIF-1α levels were analyzed using an ELISA. Results: Pressure-O₂ and Pressure-O₂/CO₂ were associated with significantly better renal hemodynamics and acid-base homeostasis compared to Flow-O₂. Urine protein concentrations and the fractional excretion of sodium were lower with both Pressure-O₂ and Pressure-O₂/CO₂ than with Flow-O₂. NGAL and HIF-1α levels were also lower with Pressure-O₂ and Pressure-O₂/CO₂ than with Flow-O₂. Only Pressure-O₂/CO₂ could demonstrate a significantly increased urine production compared to Flow-O₂. The structural integrity was well preserved in the Pressure-O₂ and Pressure-O₂/CO₂ groups, whereas diffuse and global glomerular destruction was observed in the Flow-O₂ group. Conclusion: In the IPPK model, the application of pressure-controlled reperfusion with carbogen oxygenation, and to a lesser extent with pure oxygen, maintained physiological renal function for 1 h, thus providing a reliable and reproducible ex vivo evaluation of kidney preservation quality.

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Hypothermic machine perfusion after static cold storage does not improve the preservation condition in an experimental porcine kidney model

Abstract: This porcine kidney study demonstrated no advantage to the addition of 4 h of HMP after CS.

Cited by 33 publications

References 34 publications

Short, Cool, and Well Oxygenated – HOPE for Kidney Transplantation in a Rodent Model

Short, Cool, and Well Oxygenated – HOPE for Kidney Transplantation in a Rodent Model

New Strategies and Concepts in Organ Preservation

Determination of the Preferred Conditions for the Isolated Perfusion of Porcine Kidneys

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