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Machine perfusion kidney

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https://www.readbyqxmd.com/read/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#1
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#2
María José Pérez-Sáez, Nuria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor (ECD) or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index (KDPI) policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28035688/reconditioning-by-endischaemic-hypothermic-in-house-machine-perfusion-a-promising-strategy-to-improve-outcome-in-ecd-kidney-transplantation
#3
Anja Gallinat, Vera Amrillaeva, Dieter P Hoyer, Peri Kocabayoglu, Tamas Benko, Jürgen W Treckmann, Marieke van Meel, Undine Samuel, Thomas Minor, Andreas Paul
This clinical study evaluates end-ischaemic hypothermic machine perfusion (eHMP) in ECD kidneys. eHMP was initiated upon arrival of the kidney in our center and continued until transplantation. Between 11/2011 and 8/2014 eHMP was performed in 66 ECD-kidneys for 369 (98-912) minutes after 863 (364-1567) minutes of CS. In 49 out of 66 cases the contralateral kidney from the same donor was preserved by static cold storage (CS) only and accepted by another Eurotransplant center. Fife (10.2%) of these kidneys were ultimately judged as "not transplantable" by the accepting center and discarded...
December 30, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28018757/trends-in-usage-and-outcomes-for-expanded-criteria-donor-kidney-transplantation-in-the-united-states-characterized-by-kidney-donor-profile-index
#4
Aparna Rege, Bill Irish, Anthony Castleberry, Deepak Vikraman, Scott Sanoff, Kadiyala Ravindra, Bradley Collins, Debra Sudan
There has been increasing concern in the kidney transplant community about the declining use of expanded criteria donors (ECD) despite improvement in survival and quality of life. The recent introduction of the Kidney Donor Profile Index (KDPI), which provides a more granular characterization of donor quality, was expected to increase utilization of marginal kidneys and decrease the discard rates. However, trends and practice patterns of ECD kidney utilization on a national level based on donor organ quality as per KDPI are not well known...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/27993213/an-ex%C3%A2-vivo-comparison-of-adenosine-and-lidocaine-solution-and-university-of-wisconsin-solution-for-hypothermic-machine-perfusion-of-porcine-kidneys-potential-for-development
#5
Karim Hamaoui, Adeel Aftab, Sally Gowers, Martyn Boutelle, Terry Cook, Donna Rudd, Geoffrey P Dobson, Vassilios Papalois
BACKGROUND: The optimal hypothermic machine perfusion (HMP) solution has not yet been developed. An adenosine and lidocaine (AL) solution has been shown to be protective in cardiac preservation. The aim of the present study was to examine a modified AL solution with low Ca(2+), 16 mM Mg(2+), and 4% albumin on kidney preservation compared with University Wisconsin solution (UW). METHODS: Twenty donation of organs after cardiac death porcine kidneys underwent HMP for 10 h (AL, n = 10; UW, n = 10) and then 2 h of normothermic reperfusion...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27931565/ex%C3%A2-vivo-perfusion-characteristics-of-donation-after-cardiac-death-kidneys-predict-long-term-graft-survival
#6
M Sevinc, S Stamp, J Ling, N Carter, D Talbot, N Sheerin
BACKGROUND: Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. METHODS: All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27919740/metabolic-differences-between-cold-stored-and-machine-perfused-porcine-kidneys-a-1-h-nmr-based-study
#7
Jay Nath, Tom B Smith, Kamlesh Patel, Sam R Ebbs, Alex Hollis, Daniel A Tennant, Christian Ludwig, Andrew R Ready
Hypothermic machine perfusion (HMP) and static cold storage (SCS) are the two methods used to preserve deceased donor kidneys prior to transplant. This study seeks to characterise the metabolic profile of HMP and SCS porcine kidneys in a cardiac death donor model. Twenty kidneys were cold flushed and stored for two hours following retrieval. Paired kidneys then underwent 24 h of HMP or SCS or served as time zero controls. Metabolite quantification in both storage fluid and kidney tissue was performed using one dimensional (1)H NMR spectroscopy...
December 3, 2016: Cryobiology
https://www.readbyqxmd.com/read/27906828/presence-of-cytotoxic-extracellular-histones-in-machine-perfusate-of-donation-after-circulatory-death-kidneys
#8
Tim C van Smaalen, Daniëlle M H Beurskens, E R Pieter Hoogland, Bjorn Winkens, Maarten H L Christiaans, Chris P Reutelingsperger, L W Ernest van Heurn, Gerry A F Nicolaes
BACKGROUND: Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction and thrombosis. Their role in organ donation and graft function and survival is still unknown. The aim of this study was to assess whether an association exists between the presence of extracellular histones in machine perfusates and deceased donor kidney viability...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27888556/evaluate-quality-of-kidneys-from-dcd-ecd-donors-by-parameters-of-machine-perfusion
#9
Guodong Chen, Chang Wang, Yi Zhao, Longhui Qiu, Xiaopeng Yuan, Jiang Qiu, Changxi Wang, Xiaoshun He, Lizhong Chen
AIM: To investigate whether the parameters of machine perfusion could predict the quality of kidneys from donation after circulatory death(DCD) donors and expanded criteria donors (ECD) . METHODS: 58 kidneys from DCD/ECD donors were harvested in our hospital from July 2011 to August 2014. All kidneys were preserved with machine perfusion(Life Port), and parameters of machine perfusion were collected. All kidneys were biopsied before transplantation. The primary endpoints were delayed graft function(DGF), graft loss and patient death...
November 26, 2016: Nephrology
https://www.readbyqxmd.com/read/27870928/mir-182-5p-inhibition-ameliorates-ischemic-acute-kidney-injury
#10
Julia Wilflingseder, Kíra Jelencsics, Helga Bergmeister, Judith Sunzenauer, Heinz Regele, Farsad Eskandary, Roman Reindl-Schwaighofer, Alexander Kainz, Rainer Oberbauer
Acute kidney injury (AKI) remains a major clinical event with high mortality rates. We previously identified renal miR-182 as the main driver of post-transplantation AKI. Therefore, we tested the causal inference of miR-182 by inhibiting its renal expression in vivo. In 45 rats AKI was induced by right nephrectomy and contralateral clamping of the renal pedicle for 40 minutes. Systemically administered antisense oligonucleotide (ASO) inhibited miR-182 in the kidneys up to 96 hours. The maximum creatinine elevation was on day 2 after injury (mg/dL; median and interquartile range): ASO 2...
January 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/27861293/organ-pretreatment-with-cytotopic-endothelial-localizing-peptides-to-ameliorate-microvascular-thrombosis-and-perfusion-deficits-in-ex-vivo-renal-hemoreperfusion-models
#11
Karim Hamaoui, Sally Gowers, Martyn Boutelle, Terry H Cook, George Hanna, Ara Darzi, Richard Smith, Anthony Dorling, Vassilios Papalois
BACKGROUND: Hypothermic machine organ perfusion (HMP) offers opportunity to manipulate grafts with pharmacological agents prior to transplantation. Pretreating organs with novel cytotopic anticoagulant peptides that localize to endothelial cell membranes could ameliorate microvascular thrombotic sequelae posttransplantation. We describe experiments testing thrombalexin (TLN), a novel cell binding thrombin inhibitor, using porcine and unused human kidneys in a series of ex vivo normothermic hemoreperfusion models...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27749583/maximizing-kidneys-for-transplantation-using-machine-perfusion-from-the-past-to-the-future-a-comprehensive-systematic-review-and-meta-analysis
#12
REVIEW
Ahmer M Hameed, Henry C Pleass, Germaine Wong, Wayne J Hawthorne
BACKGROUND: The two main options for renal allograft preservation are static cold storage (CS) and machine perfusion (MP). There has been considerably increased interest in MP preservation of kidneys, however conflicting evidence regarding its efficacy and associated costs have impacted its scale of clinical uptake. Additionally, there is no clear consensus regarding oxygenation, and hypo- or normothermia, in conjunction with MP, and its mechanisms of action are also debated. The primary aims of this article were to elucidate the benefits of MP preservation with and without oxygenation, and/or under normothermic conditions, when compared with CS prior to deceased donor kidney transplantation...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27742321/beneficial-effect-of-extracorporeal-membrane-oxygenation-on-organ-perfusion-during-management-of-the-unstable-brain-dead-donor-a%C3%A2-case-series
#13
J H Kang, B H Choi, K M Moon, Y M Park, K H Yang, J H Ryu, C W Chu
It is well known that the quality of organs retrieved from brain-dead donors (DBDs) is better than those retrieved from circulatory death donors. However, in situations of organ retrieval from marginal DBDs, who are unstable despite intensive care, transplantation outcomes are not good. Organ ischemia is the most important determining factor in decreased organ quality in circulatory death donors and in some DBDs. Extracorporeal membrane oxygenation (ECMO) for management of DBDs can be an emergency countermeasure...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27718228/prediction-of-renal-function-upon-reperfusion-by-ex-situ-controlled-oxygenated-rewarming
#14
Thomas Minor, Katja Sutschet, Oliver Witzke, Andreas Paul, Anja Gallinat
BACKGROUND: Post-transplant function of suboptimal kidney grafts can be improved but not accurately predicted by hypothermic machine perfusion. Therefore, a new concept of ex situ pre-implantation machine perfusion with controlled rewarming up to subnormothermic temperatures was developed and evaluated. MATERIALS AND METHODS: Porcine kidneys (n = 6/group) were retrieved before or 30 min after cardiac arrest of the donor and subjected to 18 h of static cold storage...
December 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27693279/-ischemia-reperfusion-preservation-solution-and-hypothermic-machine-perfusion
#15
B Barrou, N Chatauret, T Hauet, R Thuret, F Kleinclauss, M-O Timsit, R Codas, X Matillon, L Badet
AIMS: To describe ischemia-reperfusion mechanisms, the impact on kidney graft and strategies developed to minimize ischemia-reperfusion damages. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords: ischemia-reperfusion; organ preservation; hypothermic machine perfusion; renal transplantation...
November 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27661660/adding-medicine-during-machine-perfusion-a-breakthrough-in-kidney-transplantation
#16
Bente Jespersen
No abstract text is available yet for this article.
December 2016: Transplantation
https://www.readbyqxmd.com/read/27556029/beneficial-effect-of-short-pretransplant-period-of-hypothermic-pulsatile-perfusion-of-the-warm-ischemic-kidney-after-cold-storage-experimental-study
#17
Alberto Lázaro, Blanca Humanes, Juan Carlos Jado, Marina Mojena, María Ángeles González-Nicolás, Juan Francisco Del Cañizo, Alberto Tejedor, Enrique Lledó-García
Warm ischemia (WI) produces a significant deleterious effect in potential kidney grafts. Hypothermic machine perfusion (HMP) seems to improve immediate graft function after transplant. Our aim was to analyze the effect of short pretransplant periods of pulsatile HMP on histology and renal injury in warm-ischemic kidneys. Twelve minipigs were used. WI was achieved in the right kidney by applying a vascular clamp for 45 min. After nephrectomy, autotransplant was performed following one of two strategies: cold storage of the kidneys or cold storage combined with perfusion in pulsatile HMP...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27543840/prediction-prevention-and-management-of-delayed-graft-function-where-are-we-now
#18
Björn Nashan, Mario Abbud-Filho, Franco Citterio
Delayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High-risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post-transplant, such as neutrophil gelatinase-associated lipocalin (NGAL), are under investigation. Donor management to minimize the profound physiological consequences of brain death is highly complex. A hormonal resuscitation package to manage the catecholamine "storm" that follows brain death is recommended...
October 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27499851/-13-c-glucose-labelling-studies-using-2d-nmr-are-a-useful-tool-for-determining-ex-vivo-whole-organ-metabolism-during-hypothermic-machine-perfusion-of-kidneys
#19
Jay Nath, Tom Smith, Alex Hollis, Sam Ebbs, Sefa W Canbilen, Daniel A Tennant, Andrew R Ready, Christian Ludwig
BACKGROUND: The aim of this study is to determine the feasibility of using nuclear magnetic resonance (NMR) tracer studies ((13)C-enriched glucose) to detect ex vivo de novo metabolism in the perfusion fluid and cortical tissue of porcine kidneys during hypothermic machine perfusion (HMP). METHODS: Porcine kidneys (n = 6) were subjected to 24 h of HMP using the Organ Recovery Systems LifePort Kidney perfusion device. Glucose, uniformly enriched with the stable isotope (13)C ([U-(13)C] glucose), was incorporated into KPS-1-like perfusion fluid at a concentration of 10 mM...
2016: Transplantation Research
https://www.readbyqxmd.com/read/27495754/organ-pretreatment-with-cytotopic-endothelial-localising-peptides-to-ameliorate-microvascular-thrombosis-perfusion-deficits-in-ex-vivo-renal-haemo-reperfusion-models
#20
Karim Hamaoui, Sally Gowers, Martyn Boutelle, Terry Cook, George Hanna, Ara Darzi, Richard Smith, Anthony Dorling, Vassilios Papalois
BACKGROUND: Hypothermic machine organ perfusion (HMP) offers opportunity to manipulate grafts with pharmacological agents prior to transplantation. Pretreating organs with novel cytotopic anti-coagulant peptides that localise to endothelial cell membranes could ameliorate microvascular thrombotic sequelae posttransplantation. We describe experiments testing Thrombalexin (TLN), a novel cell binding thrombin-inhibitor, using porcine and unused human kidneys in a series of ex-vivo normothermic haemo-reperfusion models...
August 5, 2016: Transplantation
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