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

Kron, Philipp; Schlegel, Andrea; Rougemont, Olivier de; Oberkofler, Christian E.; Clavien, Pierre‐Alain; Dutkowski, Philipp

doi:10.1097/sla.0000000000001766

Cited by 68 publications

(77 citation statements)

References 35 publications

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“…This result is in contrast to a recent study in a rat model demonstrating a benefit of end-ischemic oxygenated HMP after SCS 23. AST, aspartate aminotransaminase; HMP, hypothermic machine perfusion; HMPO2, oxygenated hypothermic machine perfusion; LDH, lactate dehydrogenase; NP, normothermic perfusion; SCS, static cold storage4 | D ISCUSS I ONThis ischemia-reperfusion porcine kidney autotransplant model is the first animal study on early renal function that compares different continuous, end-ischemic, and SCS preservation strategies with the aim to determine the machine perfusion strategy that offers the best graft outcome.…”

contrasting

confidence: 99%

“…23 However, it should be stressed that in the latter study, the perfusate oxygen concentration was higher than in our protocol (450-600 vs 220-240 mm Hg). 23 However, it should be stressed that in the latter study, the perfusate oxygen concentration was higher than in our protocol (450-600 vs 220-240 mm Hg).…”

Section: Evolution Of Postoperative Serum Ldh and Astcontrasting

confidence: 57%

“…During the past 10-15 years, dynamic preservation strategies have been reintroduced as a method of organ preservation with the aim to recondition the kidney during preservation, decrease ischemia-reperfusion injury, and improve early and late graft function. [20][21][22][23] Additionally, continuous NP was explored in a porcine kidney transplant model to evaluate feasibility 24,25 and demonstrated a positive effect on early graft function. 17 More recently, end-ischemic strategies have been shown to decrease the incidence of DGF by using HMP 18 or normothermic perfusion (NP) 19 after a period of SCS compared with SCS alone.…”

mentioning

confidence: 99%

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The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia–reperfusion autotransplant model

Darius¹,

Gianello

Vergauwen

et al. 2019

American Journal of Transplantation

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The aims of this study were to determine the most optimal timing to start machine perfusion during kidney preservation to improve early graft function and to evaluate the impact of temperature and oxygen supply during machine perfusion in a porcine ischemia-reperfusion autotransplant model. The left kidney of an approximately 40-kg female Belgian Landrace pig was exposed to 30 minutes of warm ischemia via vascular clamping and randomized to 1 of 6 study groups: (1) 22-hour static cold storage (SCS) (n = 6), (2) 22-hour hypothermic machine perfusion (HMP) (n = 6), (3) 22-hour oxygenated HMP (n = 7), (4) 20-hour HMP plus 2-hour normothermic perfusion (NP) (n = 6), (5) 20-hour SCS plus 2-hour oxygenated HMP (n = 7), and (6) 20-hour SCS plus 2-hour NP (n = 6). Graft recovery measured by serum creatinine level was significantly faster for continuous HMP preservation strategies compared with SCS alone and for all end-ischemic strategies. The active oxygenated 22-hour HMP group demonstrated a significantly faster recovery from early graft function compared with the 22-hour nonactive oxygenated HMP group. Active oxygenation was also found to be an important modulator of a faster increase in renal flow during HMP preservation. Continuous oxygenated HMP applied from the time of kidney procurement until transplant might be the best preservation strategy to improve early graft function.

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contrasting

confidence: 99%

Section: Evolution Of Postoperative Serum Ldh and Astcontrasting

confidence: 57%

mentioning

confidence: 99%

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The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia–reperfusion autotransplant model

Darius¹,

Gianello

Vergauwen

et al. 2019

American Journal of Transplantation

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“…[3][4][5] We agree with Monbaliu et al 1 that cold ischemia should be reduced as much as possible in DCD livers, as for any marginal graft. However, reliable thresholds for cold ischemia, related to irreversible IC, remain difficult to determine.…”

supporting

confidence: 68%

Reply to “Reducing Nonanastomotic Biliary Strictures in Donation After Circulatory Death Liver Transplantation

et al. 2017

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“…Rat and pigs receiving kidneys treated with oxygenated HMP show faster return to normal serum creatinine post-transplantation compared to SCS [15, 16]. Similarly, pig and rat livers actually replenish tissue adenosine triphosphate (ATP) during oxygenated HMP, resulting in improved preservation of the bile ducts [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Opportunities for Therapeutic Intervention During Machine Perfusion

Karimian

Yeh

2017

Curr Transpl Rep

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Purpose of review There is a vast discrepancy between the number of patients waiting for organ transplantation and the available donor organs. Ex vivo machine perfusion (MP) has emerged in an effort to expand the donor pool, by improving organ preservation, providing diagnostic information, and more recently, acting as a platform for organ improvement. This article reviews the current status of MP with a focus on its role in organ preconditioning and therapeutic interventions prior to transplantation. Recent findings MP has allowed longer organ preservation compared to conventional static cold storage and allowed the use of organs that might otherwise have been discarded. Moreover, experimental studies have investigated the role of MP in reducing ischemia reperfusion injury of lungs, kidneys and livers by applying mesenchymal stem cells (MSCs), anti-inflammatory agents, cytotopic anticoagulants, and defatting cocktails. Summary MP has opened a new era in the field of organ transplantation and tissue medication.

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

Cited by 68 publications

References 35 publications

The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia–reperfusion autotransplant model

The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia–reperfusion autotransplant model

Reply to “Reducing Nonanastomotic Biliary Strictures in Donation After Circulatory Death Liver Transplantation

Opportunities for Therapeutic Intervention During Machine Perfusion

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