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Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model.
J Surg Res 2016; 200(1):332-45JS

Abstract

BACKGROUND

Viability assessment during preservation is imperative to avoid unnecessary discard of marginal organs maximizing graft outcomes in kidney transplantation. To address this need, we have developed a novel system based on a rapid sampling microdialysis (rsMD) analyzer allowing continuous tissue monitoring and measurement of metabolic markers of cell damage. Our aim was to develop a tool that allows for accurate assessment of tissue metabolism and organ viability in the preservation period.

METHODS

Twenty-two porcine kidneys subjected to 15 min of warm ischemia underwent either 24 h of static cold storage (SCS) or 10 h of hypothermic machine perfusion (HMP). After preservation, tissue temperature was allowed to passively increase to ambient temperature as an ischemic challenge. Cortical and medullary metabolism was monitored throughout with online measurements of lactate concentrations made every 60 s.

RESULTS

On commencement of monitoring, lactate concentrations were successfully detected within 15 mins. During the initial 1.5 h, lactate concentrations were similar during SCS (65 μM) and HMP (124 μM, P > 0.05) but lower after 10 h of SCS (SCS: 68 μM versus HMP: 230 μM, P < 0.001). Warming data suggest a resilience of HMP kidneys to subsequent temperature induced ischemia compared to SCS kidneys.

CONCLUSIONS

This preliminary study provides the baseline ischemic profile for porcine kidneys while validating the technique of rsMD as a tool for organ viability assessment during preservation. The data characterize metabolic differences between SCS and HMP preserved allografts and can help elucidate why HMP is clinically superior to SCS allowing development of interventions to augment these benefits.

Authors+Show Affiliations

Department of Surgery, Imperial College London, London, United Kingdom. Electronic address: karim.hamaoui08@imperial.ac.uk.Department of Bioengineering, Imperial College London, London, United Kingdom.Department of Surgery, Imperial College London, London, United Kingdom.Department of Bioengineering, Imperial College London, London, United Kingdom.Department of Bioengineering, Imperial College London, London, United Kingdom.Department of Surgery, Imperial College London, London, United Kingdom.Department of Surgery, Imperial College London, London, United Kingdom.Department of Bioengineering, Imperial College London, London, United Kingdom.Department of Surgery, Imperial College London, London, United Kingdom; Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26323367

Citation

Hamaoui, Karim, et al. "Rapid Sampling Microdialysis as a Novel Tool for Parenchyma Assessment During Static Cold Storage and Hypothermic Machine Perfusion in a Translational Ex Vivo Porcine Kidney Model." The Journal of Surgical Research, vol. 200, no. 1, 2016, pp. 332-45.
Hamaoui K, Gowers S, Damji S, et al. Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model. J Surg Res. 2016;200(1):332-45.
Hamaoui, K., Gowers, S., Damji, S., Rogers, M., Leong, C. L., Hanna, G., ... Papalois, V. (2016). Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model. The Journal of Surgical Research, 200(1), pp. 332-45. doi:10.1016/j.jss.2015.07.004.
Hamaoui K, et al. Rapid Sampling Microdialysis as a Novel Tool for Parenchyma Assessment During Static Cold Storage and Hypothermic Machine Perfusion in a Translational Ex Vivo Porcine Kidney Model. J Surg Res. 2016;200(1):332-45. PubMed PMID: 26323367.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model. AU - Hamaoui,Karim, AU - Gowers,Sally, AU - Damji,Samir, AU - Rogers,Michelle, AU - Leong,Chi Leng, AU - Hanna,George, AU - Darzi,Ara, AU - Boutelle,Martyn, AU - Papalois,Vassilios, Y1 - 2015/07/09/ PY - 2015/05/20/received PY - 2015/06/24/revised PY - 2015/07/02/accepted PY - 2015/9/2/entrez PY - 2015/9/2/pubmed PY - 2016/5/3/medline KW - Ischaemia KW - Machine perfusion KW - Metabolism KW - Micro-dialysis KW - Preservation KW - Tissue viability SP - 332 EP - 45 JF - The Journal of surgical research JO - J. Surg. Res. VL - 200 IS - 1 N2 - BACKGROUND: Viability assessment during preservation is imperative to avoid unnecessary discard of marginal organs maximizing graft outcomes in kidney transplantation. To address this need, we have developed a novel system based on a rapid sampling microdialysis (rsMD) analyzer allowing continuous tissue monitoring and measurement of metabolic markers of cell damage. Our aim was to develop a tool that allows for accurate assessment of tissue metabolism and organ viability in the preservation period. METHODS: Twenty-two porcine kidneys subjected to 15 min of warm ischemia underwent either 24 h of static cold storage (SCS) or 10 h of hypothermic machine perfusion (HMP). After preservation, tissue temperature was allowed to passively increase to ambient temperature as an ischemic challenge. Cortical and medullary metabolism was monitored throughout with online measurements of lactate concentrations made every 60 s. RESULTS: On commencement of monitoring, lactate concentrations were successfully detected within 15 mins. During the initial 1.5 h, lactate concentrations were similar during SCS (65 μM) and HMP (124 μM, P > 0.05) but lower after 10 h of SCS (SCS: 68 μM versus HMP: 230 μM, P < 0.001). Warming data suggest a resilience of HMP kidneys to subsequent temperature induced ischemia compared to SCS kidneys. CONCLUSIONS: This preliminary study provides the baseline ischemic profile for porcine kidneys while validating the technique of rsMD as a tool for organ viability assessment during preservation. The data characterize metabolic differences between SCS and HMP preserved allografts and can help elucidate why HMP is clinically superior to SCS allowing development of interventions to augment these benefits. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/26323367/Rapid_sampling_microdialysis_as_a_novel_tool_for_parenchyma_assessment_during_static_cold_storage_and_hypothermic_machine_perfusion_in_a_translational_ex vivo_porcine_kidney_model_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(15)00749-0 DB - PRIME DP - Unbound Medicine ER -