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A pilot study assessing the feasibility of a short period of normothermic preservation in an experimental model of non heart beating donor kidneys.
J Surg Res. 2011 Nov; 171(1):283-90.JS

Abstract

BACKGROUND

Restoring metabolism to an organ after hypothermic storage and before transplantation could reverse some of the detrimental effects of ischemic injury. This may be particularly beneficial for kidneys from non-heart-beating (NHBD) donors that sustain significant periods of warm and cold ischemic injury. This pilot study assessed the feasibility of a short period of normothermic preservation (NP) in a porcine autotransplant model.

METHODS

Kidneys were subjected to 30 min of warm ischemia, then preserved by hypothermic machine perfusion (HMP) for 22 h or 20 h HMP followed by 2 h of NP using autologous blood. Kidneys were then re-implanted, a contralateral nephrectomy performed, and renal function measured over 10 d.

RESULTS

Post-transplant, 4/6 animals survived in the NP group compared with 5/6 in the HMP group (P = 1.00). Creatinine levels fell below 250 μmol/L in all four of the surviving animals in the NP group compared with 2/5 in the HMP group (P = 0.608). There was no difference in levels of renal function (peak creatinine, HMP = 1736 ± 866 versus NP = 1553 ± 516 μmol/L; P ≥ 0.990). Levels of lipid peroxidation were significantly lower 60 min post-transplant in the NP group (NP = 477 ± 118.0 versus HMP = 671 ± 99.4 pg/mL; P = 0.026).

CONCLUSION

A period of NP at the end of the renal preservation period in NHB kidneys is a feasible method of kidney preservation. NP could prove to be a useful technique to predetermine graft function and allow pre-transplant modification of organs.

Authors+Show Affiliations

Transplant Group, Department of Infection, Immunity and Inflammation, University of Leicester, UK. sarahhosgood@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20421113

Citation

Hosgood, Sarah A., et al. "A Pilot Study Assessing the Feasibility of a Short Period of Normothermic Preservation in an Experimental Model of Non Heart Beating Donor Kidneys." The Journal of Surgical Research, vol. 171, no. 1, 2011, pp. 283-90.
Hosgood SA, Barlow AD, Yates PJ, et al. A pilot study assessing the feasibility of a short period of normothermic preservation in an experimental model of non heart beating donor kidneys. J Surg Res. 2011;171(1):283-90.
Hosgood, S. A., Barlow, A. D., Yates, P. J., Snoeijs, M. G., van Heurn, E. L., & Nicholson, M. L. (2011). A pilot study assessing the feasibility of a short period of normothermic preservation in an experimental model of non heart beating donor kidneys. The Journal of Surgical Research, 171(1), 283-90. https://doi.org/10.1016/j.jss.2010.01.027
Hosgood SA, et al. A Pilot Study Assessing the Feasibility of a Short Period of Normothermic Preservation in an Experimental Model of Non Heart Beating Donor Kidneys. J Surg Res. 2011;171(1):283-90. PubMed PMID: 20421113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pilot study assessing the feasibility of a short period of normothermic preservation in an experimental model of non heart beating donor kidneys. AU - Hosgood,Sarah A, AU - Barlow,Adam D, AU - Yates,Phillip J, AU - Snoeijs,Maarten G J, AU - van Heurn,Ernest L W, AU - Nicholson,Michael L, Y1 - 2010/02/11/ PY - 2009/12/14/received PY - 2009/12/14/revised PY - 2010/01/14/accepted PY - 2010/4/28/entrez PY - 2010/4/28/pubmed PY - 2012/1/10/medline SP - 283 EP - 90 JF - The Journal of surgical research JO - J Surg Res VL - 171 IS - 1 N2 - BACKGROUND: Restoring metabolism to an organ after hypothermic storage and before transplantation could reverse some of the detrimental effects of ischemic injury. This may be particularly beneficial for kidneys from non-heart-beating (NHBD) donors that sustain significant periods of warm and cold ischemic injury. This pilot study assessed the feasibility of a short period of normothermic preservation (NP) in a porcine autotransplant model. METHODS: Kidneys were subjected to 30 min of warm ischemia, then preserved by hypothermic machine perfusion (HMP) for 22 h or 20 h HMP followed by 2 h of NP using autologous blood. Kidneys were then re-implanted, a contralateral nephrectomy performed, and renal function measured over 10 d. RESULTS: Post-transplant, 4/6 animals survived in the NP group compared with 5/6 in the HMP group (P = 1.00). Creatinine levels fell below 250 μmol/L in all four of the surviving animals in the NP group compared with 2/5 in the HMP group (P = 0.608). There was no difference in levels of renal function (peak creatinine, HMP = 1736 ± 866 versus NP = 1553 ± 516 μmol/L; P ≥ 0.990). Levels of lipid peroxidation were significantly lower 60 min post-transplant in the NP group (NP = 477 ± 118.0 versus HMP = 671 ± 99.4 pg/mL; P = 0.026). CONCLUSION: A period of NP at the end of the renal preservation period in NHB kidneys is a feasible method of kidney preservation. NP could prove to be a useful technique to predetermine graft function and allow pre-transplant modification of organs. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/20421113/A_pilot_study_assessing_the_feasibility_of_a_short_period_of_normothermic_preservation_in_an_experimental_model_of_non_heart_beating_donor_kidneys_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(10)00047-8 DB - PRIME DP - Unbound Medicine ER -