Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring

Resch, Thomas; Cardini, Benno; Oberhuber, Rupert; Weißenbacher, Annemarie; Dumfarth, Julia; Krapf, Christoph; Boesmueller, C.; Oefner, Dietmar; Grimm, Michael; Schneeberger, S.

doi:10.3389/fimmu.2020.00631

Cited by 87 publications

(80 citation statements)

References 191 publications

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“…The tissue level of adenosine triphosphate (ATP) is a long-established marker of graft viability and functionality and is universal for all solid organ transplants (22). ATP is also a marker of the viability of machine-perfusion treated grafts (23). The Branchereau study highlighted that the tissuebiopsies of the pancreases in the HMP-group had a higher concentration of ATP levels when compared to the control group (21,24).…”

Section: The Rationale Of Organ Preservation By Machine Perfusionmentioning

confidence: 99%

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

et al. 2020

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Section: The Rationale Of Organ Preservation By Machine Perfusionmentioning

confidence: 99%

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

et al. 2020

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“…This suggests significant change in graft metabolism during machine perfusion. It is currently unknown if modulations such as cold or warm perfusion can revert this metabolic reprogramming or whether this can improve a posttransplantation outcome 67 …”

Section: Discussionmentioning

confidence: 99%

“…It is currently unknown if modulations such as cold or warm perfusion can revert this metabolic reprogramming or whether this can improve a posttransplantation outcome. 67 This approach has several limitations. The Langendorff set-up does not replicate fully optimal physiological conditions when compared with more challenging models, such as the working heart model.…”

Section: Discussionmentioning

confidence: 99%

Development of a human heart‐sized perfusion system for metabolic imaging studies using hyperpolarized [1‐¹³C]pyruvate MRI

Mariager

Hansen

Bech

et al. 2020

Magnetic Resonance in Med

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Purpose Increasing worldwide demand for cardiac transplantation has spurred new developments to increase the donor pool. Normothermic preservation of heart grafts for transplantation is an emerging strategy to improve the utilization of marginal grafts. Hyperpolarized MR using metabolic tracers such as [1‐13C]pyruvate, provide a novel means of investigating metabolic status without the use of ionizing radiation. We demonstrate the use of this methodology to examine ex vivo perfused porcine heart grafts. Methods Hearts from three 40‐kg Danish domestic pigs were harvested and subsequently perfused in Langendorff mode under normothermic conditions, using an MR‐compatible perfusion system adapted to the heart. Proton MRI and hyperpolarized [1‐13C]pyruvate were used to investigate and quantify the functional and metabolic status of the grafts. Results Hearts were perfused with whole blood for 120 min, using a dynamic contrast‐enhanced perfusion experiment to verify successful myocardial perfusion. Hyperpolarized [1‐13C]pyruvate MRI was used to assess the metabolic state of the myocardium. Functional assessment was performed using CINE imaging and ventricular pressure data. High lactate and modest alanine levels were observed in the hyperpolarized experiment. The functional assessment produced reduced functional parameters. This suggests an altered functional and metabolic profile compared with corresponding in vivo values. Conclusion We investigated the metabolic and functional status of machine‐perfused porcine hearts. Utilizing hyperpolarized methodology to acquire detailed myocardial metabolic information—in combination with already established MR methods for cardiac investigation—provides a powerful tool to aid the progress of donor heart preservation.

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“…The results achieved with this 'new' technology are encouraging. 12 The use of this device is limited for several reasons: cost, required medical staff, etc. A simpler solution might be to add an oxygen carrier to SCS.…”

Section: Coagulation In Cirrhosis Is a Complex Issue Where The Classical Tests (International Normalized Ratio [Inr] Activated Partial Thmentioning

confidence: 99%

Quality and reproducibility during the COVID-19 pandemic

Gustot

2020

JHEP Reports

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Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring

Cited by 87 publications

References 191 publications

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

Development of a human heart‐sized perfusion system for metabolic imaging studies using hyperpolarized [1‐¹³C]pyruvate MRI

Quality and reproducibility during the COVID-19 pandemic

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Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring

Cited by 87 publications

References 191 publications

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

Organ Restoration With Normothermic Machine Perfusion and Immune Reaction

Development of a human heart‐sized perfusion system for metabolic imaging studies using hyperpolarized [1‐13C]pyruvate MRI

Quality and reproducibility during the COVID-19 pandemic

Contact Info

Product

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Development of a human heart‐sized perfusion system for metabolic imaging studies using hyperpolarized [1‐¹³C]pyruvate MRI