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Oxygen Consumption by Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation.

Abstract

Static cold storage (SCS) and hypothermic machine perfusion (HMP) are currently standard methods for renal grafts clinical preservation. Both methods are predominantly implemented without the active delivery of oxygen, even for donation after circulatory death-like kidneys. However, even under severe hypothermia (4°C-6°C), kidneys can consume oxygen and produce ATP. What is not established, though, is to what extent and how SCS and HMP compare in terms of oxygen. Using a porcine preclinical model of renal warm ischemia (WI) to compare SCS and HMP methods, we continuously monitored and quantified oxygen level and consumption along preservation; we also determined prepreservation and postpreservation cortical ATP level; values were given as median and [min; max] range. One-hour WI reduced ATP by ∼90% (from 3.3 [1.7; 4.5] mmol/L tissue in Controls). Oxygen consumption (QO2, μmol/min per 100 g) was determined from initial solution PO2 decrease (SCS and HMP) and from arterio-venous difference (HMP). In SCS and HMP, PO2 decreased rapidly (t1/2 ∼1 h) from atmospheric levels to 52.9 [38.0; 65.9] and 8.2 [3.0, 16.0] mmHg, respectively. In HMP, QO2 was 2.7 [0.4; 3.9] versus 0.5 [0.0; 1.3] in SCS (P < 0.05); postpreservation ATP amounted to 5.8 [3.2; 6.5] in HMP versus 0.1 [0.0; 0.2] in SCS. Despite hypothermic conditions in SCS or HMP, donation after circulatory death-like renal grafts require oxygen. Increased oxygen consumption, restored ATP level, and improved histological profile in HMP might explain the established HMP superiority over SCS. These results establish a rational basis for the use of oxygen in hypothermic preservation. Optimal levels required for preservation and graft-type variants remain to be determined.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    INSERM U1082-IRTOMIT, CHU de Poitiers, Poitiers, France.

    ,

    INSERM U1082-IRTOMIT, CHU de Poitiers, Poitiers, France; Service d'Urologie, CHU de Poitiers, Poitiers, France.

    ,

    INSERM U1082-IRTOMIT, CHU de Poitiers, Poitiers, France.

    ,

    Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Édouard-Herriot, Université Claude-Bernard Lyon 1, Lyon, France.

    ,

    INSERM U1082-IRTOMIT, CHU de Poitiers, Poitiers, France; Service de Biochimie, CHU de Poitiers, Poitiers, France.

    INSERM U1082-IRTOMIT, CHU de Poitiers, Poitiers, France. Electronic address: patrick.hannaert@univ-poitiers.fr.

    Source

    The Journal of surgical research 242: 2019 May 06 pg 78-86

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31071608

    Citation

    Kaminski, Jacques, et al. "Oxygen Consumption By Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation." The Journal of Surgical Research, vol. 242, 2019, pp. 78-86.
    Kaminski J, Delpech PO, Kaaki-Hosni S, et al. Oxygen Consumption by Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation. J Surg Res. 2019;242:78-86.
    Kaminski, J., Delpech, P. O., Kaaki-Hosni, S., Promeyrat, X., Hauet, T., & Hannaert, P. (2019). Oxygen Consumption by Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation. The Journal of Surgical Research, 242, pp. 78-86. doi:10.1016/j.jss.2019.04.015.
    Kaminski J, et al. Oxygen Consumption By Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation. J Surg Res. 2019 May 6;242:78-86. PubMed PMID: 31071608.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Oxygen Consumption by Warm Ischemia-Injured Porcine Kidneys in Hypothermic Static and Machine Preservation. AU - Kaminski,Jacques, AU - Delpech,Pierre-Olivier, AU - Kaaki-Hosni,Sihem, AU - Promeyrat,Xavier, AU - Hauet,Thierry, AU - Hannaert,Patrick, Y1 - 2019/05/06/ PY - 2018/09/14/received PY - 2019/03/26/revised PY - 2019/04/04/accepted PY - 2019/5/10/pubmed PY - 2019/5/10/medline PY - 2019/5/10/entrez KW - ATP KW - Hypothermic machine perfusion KW - Ischemia-reperfusion KW - Kidney KW - Oxygen KW - Preservation KW - Static cold storage SP - 78 EP - 86 JF - The Journal of surgical research JO - J. Surg. Res. VL - 242 N2 - Static cold storage (SCS) and hypothermic machine perfusion (HMP) are currently standard methods for renal grafts clinical preservation. Both methods are predominantly implemented without the active delivery of oxygen, even for donation after circulatory death-like kidneys. However, even under severe hypothermia (4°C-6°C), kidneys can consume oxygen and produce ATP. What is not established, though, is to what extent and how SCS and HMP compare in terms of oxygen. Using a porcine preclinical model of renal warm ischemia (WI) to compare SCS and HMP methods, we continuously monitored and quantified oxygen level and consumption along preservation; we also determined prepreservation and postpreservation cortical ATP level; values were given as median and [min; max] range. One-hour WI reduced ATP by ∼90% (from 3.3 [1.7; 4.5] mmol/L tissue in Controls). Oxygen consumption (QO2, μmol/min per 100 g) was determined from initial solution PO2 decrease (SCS and HMP) and from arterio-venous difference (HMP). In SCS and HMP, PO2 decreased rapidly (t1/2 ∼1 h) from atmospheric levels to 52.9 [38.0; 65.9] and 8.2 [3.0, 16.0] mmHg, respectively. In HMP, QO2 was 2.7 [0.4; 3.9] versus 0.5 [0.0; 1.3] in SCS (P < 0.05); postpreservation ATP amounted to 5.8 [3.2; 6.5] in HMP versus 0.1 [0.0; 0.2] in SCS. Despite hypothermic conditions in SCS or HMP, donation after circulatory death-like renal grafts require oxygen. Increased oxygen consumption, restored ATP level, and improved histological profile in HMP might explain the established HMP superiority over SCS. These results establish a rational basis for the use of oxygen in hypothermic preservation. Optimal levels required for preservation and graft-type variants remain to be determined. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/31071608/Oxygen_Consumption_by_Warm_Ischemia-Injured_Porcine_Kidneys_in_Hypothermic_Static_and_Machine_Preservation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(19)30202-1 DB - PRIME DP - Unbound Medicine ER -