Improved Normothermic Machine Perfusion After Short Oxygenated Hypothermic Machine Perfusion of Ischemically Injured Porcine Kidneys

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Stina Lignell
  • ,
  • Stine Lohmann
  • Kaithlyn M Rozenberg, University of Oxford
  • ,
  • Henri G D Leuvenink, University Medical Center Groningen, University of Groningen, Groningen
  • ,
  • Merel B F Pool, University Medical Center Groningen, University of Groningen, Groningen
  • ,
  • Kate R Lewis, University Medical Center Groningen, University of Groningen, Groningen
  • ,
  • Cyril Moers, University Medical Center Groningen, University of Groningen, Groningen
  • ,
  • James P Hunter, University of Oxford
  • ,
  • Rutger J Ploeg, University of Oxford
  • ,
  • Marco Eijken
  • Ulla Møldrup
  • Søren Krag
  • ,
  • Carla C Baan, Erasmus University Medical Center
  • ,
  • Bjarne Kuno Møller
  • Anna Krarup Keller
  • Bente Jespersen

Background: In an era where global kidney shortage has pushed the field of transplantation towards using more marginal donors, modified kidney preservation techniques are currently being reviewed. Some techniques require further optimization before implementation in full scale transplantation studies. Using a porcine donation after circulatory death kidney model, we investigated whether initial kidney hemodynamics improved during normothermic machine perfusion if this was preceded by a short period of oxygenated hypothermic machine perfusion (oxHMP) rather than static cold storage (SCS).

Methods: Kidneys subjected to 75 minutes of warm ischemia were randomly assigned to either SCS (n = 4) or SCS + oxHMP (n = 4), with a total cold storage time of 240 minutes. Cold preservation was followed by 120 minutes of normothermic machine perfusion with continuous measurement of hemodynamic parameters and renal function.

Results: oxHMP preserved kidneys maintained significantly lower renal resistance throughout the normothermic machine perfusion period compared to SCS kidneys (P < 0.001), reaching lowest levels at 60 minutes with means of 0.71 ± 0.35 mm Hg/mL/min/100 g (SCS) and 0.45 ± 0.15 mm Hg/mL/min/100 g (oxHMP). Accordingly, the oxHMP group had a higher mean renal blood flow versus SCS kidneys (P < 0.001). oxHMP kidneys had higher oxygen consumption during normothermic machine perfusion compared to SCS preserved kidneys (P < 0.001). Creatinine clearance remained similar between groups (P = 0.665).

Conclusions: Preceding oxHMP significantly improved initial normothermic machine perfusion hemodynamics and increased total oxygen consumption. With the long period of warm ischemia, immediate kidney function was not observed, reflected by the findings of low creatinine clearance in both groups.

OriginalsprogEngelsk
Artikelnummere653
TidsskriftTransplantation Direct
Vol/bind7
Nummer2
ISSN2373-8731
DOI
StatusUdgivet - feb. 2021

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