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Role of oxygenation in hypothermic machine perfusion of kidneys from heart beating donors.
Transplantation. 2012 Oct 27; 94(8):809-13.T

Abstract

Dynamic preservation of organ grafts by hypothermic machine perfusion (HMP) has regained broader interest to provide better outcome after transplantation. One pivotal aspect still under debate is the role of oxygenation during HMP. The present study investigates functional and molecular aspects of active oxygenation during HMP of kidneys from heart beating donors.

METHODS

Kidneys were retrieved from Landrace pigs (25-30 kg body weight) and preserved by pulsatile HMP for 21 hr. All kidneys were randomly assigned to either anoxic perfusion (MPanox) or active oxygenation of the perfusate (MPox). All grafts were then autotransplanted, and the remaining native kidney was removed at the same time. Renal integrity and function was evaluated during perfusion and for 1 week after the transplantation and the removal of the remaining native kidney.

RESULTS

Oxygenation during HMP resulted in lower endischemic vascular resistance and slightly elevated free radical-mediatedtissue injury during HMP. After reperfusion, radical mediated lipid peroxidation was twofold higher in the MPanox group. Renal clearance of creatinine was found significantly better during the first 2 days after transplantation after MPanox than after MPox. Molecular expression of erythropoietin was increased threefold to baseline levels after MPanox, indicating renal hypoxia during preservation, but was remained unchanged after MPox. Gene expression of sodium-glucose transporter reflected similar functional outcome in both groups. Fractional excretion of Na(+), proteinuria, or serum levels of lactate dehydrogenase were similar in both groups.

CONCLUSION

The present data do not support the use of active oxygenation during hypothermic perfusion of kidneys from donors with intact circulation.

Authors+Show Affiliations

Surgical Research Division, University Clinic of Surgery, Bonn, Germany.No affiliation info availableNo 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

22992766

Citation

Gallinat, Anja, et al. "Role of Oxygenation in Hypothermic Machine Perfusion of Kidneys From Heart Beating Donors." Transplantation, vol. 94, no. 8, 2012, pp. 809-13.
Gallinat A, Paul A, Efferz P, et al. Role of oxygenation in hypothermic machine perfusion of kidneys from heart beating donors. Transplantation. 2012;94(8):809-13.
Gallinat, A., Paul, A., Efferz, P., Lüer, B., Swoboda, S., Hoyer, D., & Minor, T. (2012). Role of oxygenation in hypothermic machine perfusion of kidneys from heart beating donors. Transplantation, 94(8), 809-13. https://doi.org/10.1097/TP.0b013e318266401c
Gallinat A, et al. Role of Oxygenation in Hypothermic Machine Perfusion of Kidneys From Heart Beating Donors. Transplantation. 2012 Oct 27;94(8):809-13. PubMed PMID: 22992766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of oxygenation in hypothermic machine perfusion of kidneys from heart beating donors. AU - Gallinat,Anja, AU - Paul,Andreas, AU - Efferz,Patrik, AU - Lüer,Bastian, AU - Swoboda,Sandra, AU - Hoyer,Dieter, AU - Minor,Thomas, PY - 2012/9/21/entrez PY - 2012/9/21/pubmed PY - 2012/12/28/medline SP - 809 EP - 13 JF - Transplantation JO - Transplantation VL - 94 IS - 8 N2 - UNLABELLED: Dynamic preservation of organ grafts by hypothermic machine perfusion (HMP) has regained broader interest to provide better outcome after transplantation. One pivotal aspect still under debate is the role of oxygenation during HMP. The present study investigates functional and molecular aspects of active oxygenation during HMP of kidneys from heart beating donors. METHODS: Kidneys were retrieved from Landrace pigs (25-30 kg body weight) and preserved by pulsatile HMP for 21 hr. All kidneys were randomly assigned to either anoxic perfusion (MPanox) or active oxygenation of the perfusate (MPox). All grafts were then autotransplanted, and the remaining native kidney was removed at the same time. Renal integrity and function was evaluated during perfusion and for 1 week after the transplantation and the removal of the remaining native kidney. RESULTS: Oxygenation during HMP resulted in lower endischemic vascular resistance and slightly elevated free radical-mediatedtissue injury during HMP. After reperfusion, radical mediated lipid peroxidation was twofold higher in the MPanox group. Renal clearance of creatinine was found significantly better during the first 2 days after transplantation after MPanox than after MPox. Molecular expression of erythropoietin was increased threefold to baseline levels after MPanox, indicating renal hypoxia during preservation, but was remained unchanged after MPox. Gene expression of sodium-glucose transporter reflected similar functional outcome in both groups. Fractional excretion of Na(+), proteinuria, or serum levels of lactate dehydrogenase were similar in both groups. CONCLUSION: The present data do not support the use of active oxygenation during hypothermic perfusion of kidneys from donors with intact circulation. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/22992766/Role_of_oxygenation_in_hypothermic_machine_perfusion_of_kidneys_from_heart_beating_donors_ L2 - http://dx.doi.org/10.1097/TP.0b013e318266401c DB - PRIME DP - Unbound Medicine ER -