Machine perfusion for kidneys: how to do it at minimal cost

Balupuri, S.; Hoernich, Nick; Mohamed, Mostafa; Manas, DM; Kirby, John A.; Talbot, David; Strong, A.; Snowden, Chris

doi:10.1111/j.1432-2277.2001.tb00022.x

Cited by 26 publications

(9 citation statements)

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“…This has been most useful in Maastricht Category II donor kidneys as the viability of kidneys from Maastricht Category III and IV donors is usually good [3,11]. In this study, we used machine perfusion data primarily from Maastricht Category III DCD kidneys that have been transplanted to assess the relationship between these measurements and longer term graft survival and function.…”

Section: Discussionmentioning

confidence: 99%

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Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

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Carter

et al. 2016

Transplantation Proceedings

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Section: Discussionmentioning

confidence: 99%

“…In an attempt to reduce the damage caused by ischaemia, machine perfusion has been used in Newcastle since 1998 [11].…”

Section: Introductionmentioning

confidence: 99%

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

Stamp

Carter

et al. 2016

Transplantation Proceedings

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“…Durante años el único criterio válido para demostrar la viabilidad de un riñón que ha sido trasplantado era el propio trasplante. Son numerosos los trabajos que hablan sobre la posibilidad que ofrece la perfusión pulsátil para asesorar acerca de la viabilidad del trasplante y proporcionar información de la RVR, el FVR y otros parámetros hemodinámicos [46][47][48] .…”

Section: Discussionunclassified

Caracterización histológica y hemodinámica del injerto con isquemia caliente según el método de preservación

et al. 2008

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órganos de donantes a corazón parado abre una vía para solucionar la escasez de órganos para trasplante. Por la naturaleza de estos donantes los riñones sufren un periodo variable de isquemia normotérmica (IN) antes de su extracción, que puede dañar el injerto y condicionar su supervivencia. Minimizar el daño producido al riñón durante la extracción, los diferentes tipos de conservación hipotérmica y su posterior trasplante resulta clave para mejorar los resultados obtenidos con este tipo de injertos.Pretendemos evaluar mediante un modelo experimental, que somete al injerto renal a un periodo de IN, las consecuencias estructurales y hemodinámicas de la perfusión hipotérmica (PH) frente a la hipotermia simple (HS). Todo el procedimiento fue monitorizado y registrado mediante un sistema informatizado. La resistencia vascular renal (RVR) y el flujo vascular renal (FVR) fueron registrados en tiempo real tras el desclampaje. Llevamos a cabo estudio histológico mediante microscopía convencional y electrónica.Resultados: Observamos 2 patrones evolutivos post-trasplante: 1. Incremento inicial de RVR con descenso posterior e incremento del flujo vascular: órganos con IN y PH previa al trasplante (grupo B) // órganos sin isquemia previa y trasplante (grupo C-control). Microscopía convencional-electrónica: integridad túbulo-endotelial.2. Descenso inicial de RVR con incremento posterior: órganos con IN y trasplante directo (A)//órganos con isquemia previa e HS de 60 min. (D). Alteraciones túbulo-endoteliales en micro convencional-electrónica.Conclusiones: La PH en bomba preserva mejor, a nivel experimental, la ultraestructura túbulo-endotelial de los riñones sometidos a IN prolongada. La hemodinámica post-trasplante de los órganos sometidos isquemia y PH sigue un patrón similar a la de los órganos sin IN previa y trasplantados directamente.Palabras clave: Isquemia normotérmica. Preservación de órganos. ABSTRACT HYSTOLOGIC AND HEMODYNAMIC ASPECTS OF WARM ISCHEMIC GRAFT IN RELATION TO THE PRESERVATION METHODObjective: The non-heart-beating donor has been proposed as a solution to donor shortage for renal transplantation. Because the nature of such donors, the kidneys so derived have been damaged by primary warm ischemia (WI), and so potentially they may never function. Minimizing graft injury is especially important in case of transplantation form marginal donors because of a high rate of delayed graft function or primary nonfunction. The aim of this experimental study is to assess the structural and hemodynamic consequences of hypothermic perfusion (HP) versus cold storage (CS), in renal allograft after a period of WI.Material and Methods: We used 20 mini-pigs. WI was achieved by vascular pedicle occlusion during 45 min. We divided organs in 4 groups: A (n=5), kidneys with WI and then transplanted; group B (n=5), grafts with WI and implanted after HP with Belzer solution in our computerized perfusion system. Group C-control, (n=5) transplanted without WI and D (n=5) with WI and 60 min of CS in UW-Viaspan solution.All the pro...

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“…Several studies have suggested postconditioning in the setting of experimental liver and kidney transplant, with hypothermic postconditioning yielding better outcomes. [58][59][60] The role of aeration of the cold-stored liver also was clarified. A study by Schlegel and associates 61 provided evidence that machine perfusion in the complete absence of oxygen failed to prevent reperfusion injury and, instead, provoked mitochondrial and nuclear injury with the release of high mobility group box 1 protein.…”

Section: Liver Preservation Techniquesmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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There are increasing numbers of patients on liver transplant waiting lists, and there is a continuing organ shortage crisis. Therefore, more centers and organ procurement organizations are developing protocols for donation after cardiac death. However, the effect of donation after cardiac death allografts on overall patient survival remains controversial, with some centers reporting equivalent patient posttransplant survival but many others indicating increased rates of complications, retransplant, utilization of resources, and death. Several potential risk factors that predict graft loss and recipient complications have been identified. To improve patient outcomes and reduce dropouts, experimental strategies that target both donors and recipients at various phases of the transplant process have focused on attenuating ischemia-reperfusion injury and have achieved encouraging results. In the present article, our goal is to provide an overview of the current status of, and recent advances in, liver transplant from donation after cardiac death, to better understand the risks and potential benefits of donation after cardiac death liver transplant.

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Machine perfusion for kidneys: how to do it at minimal cost

Cited by 26 publications

References 14 publications

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Caracterización histológica y hemodinámica del injerto con isquemia caliente según el método de preservación

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