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

Abstract

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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  • Authors+Show Affiliations

    ,

    Surgery and Abdominal Transplant Unit, Saint Luc University, Hopital Université catholique de Louvain, Brussels, Belgium.

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    Pôle de Chirurgie Expérimentale et Transplantation, Université catholique de Louvain, Brussels, Belgium.

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    Pôle de Chirurgie Expérimentale et Transplantation, Université catholique de Louvain, Brussels, Belgium.

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    Pôle de Chirurgie Expérimentale et Transplantation, Université catholique de Louvain, Brussels, Belgium.

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    Surgery and Abdominal Transplant Unit, Saint Luc University, Hopital Université catholique de Louvain, Brussels, Belgium.

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    Surgery and Abdominal Transplant Unit, Saint Luc University, Hopital Université catholique de Louvain, Brussels, Belgium.

    Surgery and Abdominal Transplant Unit, Saint Luc University, Hopital Université catholique de Louvain, Brussels, Belgium.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30171799

    Citation

    Darius, Tom, et al. "The Effect On Early Renal Function of Various Dynamic Preservation Strategies in a Preclinical Pig Ischemia-reperfusion Autotransplant Model." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 19, no. 3, 2019, pp. 752-762.
    Darius T, Gianello P, Vergauwen M, et al. The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia-reperfusion autotransplant model. Am J Transplant. 2019;19(3):752-762.
    Darius, T., Gianello, P., Vergauwen, M., Mourad, N., Buemi, A., De Meyer, M., & Mourad, M. (2019). The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia-reperfusion autotransplant model. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 19(3), pp. 752-762. doi:10.1111/ajt.15100.
    Darius T, et al. The Effect On Early Renal Function of Various Dynamic Preservation Strategies in a Preclinical Pig Ischemia-reperfusion Autotransplant Model. Am J Transplant. 2019;19(3):752-762. PubMed PMID: 30171799.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect on early renal function of various dynamic preservation strategies in a preclinical pig ischemia-reperfusion autotransplant model. AU - Darius,Tom, AU - Gianello,Pierre, AU - Vergauwen,Martial, AU - Mourad,Nizar, AU - Buemi,Antoine, AU - De Meyer,Martine, AU - Mourad,Michel, Y1 - 2018/10/08/ PY - 2018/05/30/received PY - 2018/08/24/revised PY - 2018/08/24/accepted PY - 2018/9/2/pubmed PY - 2018/9/2/medline PY - 2018/9/2/entrez KW - animal models: porcine KW - delayed graft function (DGF) KW - kidney (native) function/dysfunction KW - kidney transplantation/nephrology KW - organ perfusion and preservation KW - organ procurement and allocation KW - organ transplantation in general KW - translational research/science SP - 752 EP - 762 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 19 IS - 3 N2 - 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. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/30171799/The_effect_on_early_renal_function_of_various_dynamic_preservation_strategies_in_a_preclinical_pig_ischemia_reperfusion_autotransplant_model_ L2 - https://doi.org/10.1111/ajt.15100 DB - PRIME DP - Unbound Medicine ER -