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Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys.
Transplant Direct. 2020 Jul; 6(7):e571.TD

Abstract

Background

The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model.

Methods

The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO2) (n = 8), and 2-hour HMPO2 + 20-hour HMP (n = 6) using membrane oxygenation in both historical oxygenated control groups.

Results

Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po2 levels during the first 2 hours of HMP with improved flow dynamics. Although the metabolic profile of the perfusate (ie, flavin mononucleotide) and tissue (ie, glutamate, ATP) after brief O2 uploading at the start of HMP seemed to be slightly better with the use of a membrane oxygenator compared with bubble and interrupted surface oxygenation, both techniques yielded similar, superior early graft function when compared with HMP without active oxygenation.

Conclusions

The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO2.

Authors+Show Affiliations

Department of Surgery, Surgery and Abdominal Transplant Unit, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary Center, University Hospital Zurich, Zurich, Switzerland.Department of Pathology, University Clinics Saint Luc, Université Catholique de Louvain, Brussels, Belgium.Department of Pathology, University Clinics Saint Luc, Université Catholique de Louvain, Brussels, Belgium.Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.Department of Surgery, Surgery and Abdominal Transplant Unit, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32766426

Citation

Darius, Tom, et al. "Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys." Transplantation Direct, vol. 6, no. 7, 2020, pp. e571.
Darius T, Vergauwen M, Mueller M, et al. Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys. Transplant Direct. 2020;6(7):e571.
Darius, T., Vergauwen, M., Mueller, M., Aydin, S., Dutkowski, P., Gianello, P., & Mourad, M. (2020). Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys. Transplantation Direct, 6(7), e571. https://doi.org/10.1097/TXD.0000000000001016
Darius T, et al. Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys. Transplant Direct. 2020;6(7):e571. PubMed PMID: 32766426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys. AU - Darius,Tom, AU - Vergauwen,Martial, AU - Mueller,Matteo, AU - Aydin,Selda, AU - Dutkowski,Philipp, AU - Gianello,Pierre, AU - Mourad,Michel, Y1 - 2020/06/11/ PY - 2020/04/22/received PY - 2020/04/27/revised PY - 2020/04/28/accepted PY - 2020/8/9/entrez PY - 2020/8/9/pubmed PY - 2020/8/9/medline SP - e571 EP - e571 JF - Transplantation direct JO - Transplant Direct VL - 6 IS - 7 N2 - Background: The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model. Methods: The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO2) (n = 8), and 2-hour HMPO2 + 20-hour HMP (n = 6) using membrane oxygenation in both historical oxygenated control groups. Results: Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po2 levels during the first 2 hours of HMP with improved flow dynamics. Although the metabolic profile of the perfusate (ie, flavin mononucleotide) and tissue (ie, glutamate, ATP) after brief O2 uploading at the start of HMP seemed to be slightly better with the use of a membrane oxygenator compared with bubble and interrupted surface oxygenation, both techniques yielded similar, superior early graft function when compared with HMP without active oxygenation. Conclusions: The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO2. SN - 2373-8731 UR - https://www.unboundmedicine.com/medline/citation/32766426/Brief_Bubble_and_Intermittent_Surface_Oxygenation_Is_a_Simple_and_Effective_Alternative_for_Membrane_Oxygenation_During_Hypothermic_Machine_Perfusion_in_Kidneys_ L2 - https://doi.org/10.1097/TXD.0000000000001016 DB - PRIME DP - Unbound Medicine ER -
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