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Machine perfusion kidney

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https://www.readbyqxmd.com/read/29758129/twenty-four-hour-normothermic-perfusion-of-discarded-human-kidneys-with-urine-recirculation
#1
Annemarie Weissenbacher, Letizia Lo Faro, Olga Boubriak, Maria F Soares, Ian S Roberts, James P Hunter, Daniel Voyce, Nikolay Mikov, Andrew Cook, Rutger J Ploeg, Constantin C Coussios, Peter J Friend
Transportable normothermic kidney perfusion for 24 hours or longer could enable viability assessment of marginal grafts, increased organ utilization and improved transplantation logistics. Eleven clinically-declined kidneys were perfused normothermically, six from donors after brain stem death (DBD, median cold ischemia time 33±36.9 hours) and five from donors after circulatory death (DCD, 36.2±38.3 hours): n=3 kidneys were perfused using Ringer's lactate to replace excreted urine volume, and n=8 using urine recirculation to maintain perfusate volume without fluid replenishment...
May 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29697462/ex-vivo-machine-perfusion-for-kidney-preservation
#2
Matyas Hamar, Markus Selzner
PURPOSE OF REVIEW: Machine perfusion is a novel strategy to decrease preservation injury, improve graft assessment, and increase organ acceptance for transplantation. This review summarizes the current advances in ex-vivo machine-based kidney preservation technologies over the last year. RECENT FINDINGS: Ex-vivo perfusion technologies, such as hypothermic and normothermic machine perfusion and controlled oxygenated rewarming, have gained high interest in the field of organ preservation...
April 24, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29607529/transplantation-of-cold-stored-porcine-kidneys-after-controlled-oxygenated-rewarming
#3
Anja Gallinat, Jing Lu, Charlotte von Horn, Moritz Kaths, Marc Ingenwerth, Andreas Paul, Thomas Minor
The concept of "controlled oxygenated rewarming" (COR) using ex vivo machine perfusion after cold storage was evaluated as tool to improve renal graft function after transplantation. Renal function after 20 min warm ischemia and 21 h cold storage was studied in an auto-transplant model in pigs (25-30 kg, n = 6 per group). In the study group, preimplant ex vivo machine perfusion for 90 min was added after cold storage, including gentle warming up of the graft to 20°C (COR). Kidneys that were only cold stored for 21 h served as controls...
April 1, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29602202/renal-resistance-trend-during-hypothermic-machine-perfusion-is-more-predictive-of-postoperative-outcome-than-biopsy-score-preliminary-experience-in-35-consecutive-kidney-transplantations
#4
Massimiliano Bissolati, Paolo Giovanni Gazzetta, Rossana Caldara, Giovanni Guarneri, Olga Adamenko, Fabio Giannone, Michele Mazza, Giulia Maggi, Deborah Tomanin, Riccardo Rosati, Antonio Secchi, Carlo Socci
Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD...
March 30, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29570164/the-benefits-of-hypothermic-machine-preservation-and-short-cold-ischemia-times-in-deceased-donor-kidneys
#5
Jjhfm Kox, C Moers, D Monbaliu, A Strelniece, J Treckmann, I Jochmans, Hgd Leuvenink, Lwe Van Heurn, J Pirenne, A Paul, R J Ploeg
BACKGROUND: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with better outcome when compared to static cold storage (CS). Nevertheless, there is little evidence whether kidneys with short cold ischemia time (CIT) also benefit from HMP and whether HMP can safely extend CIT. METHODS: We analysed prospectively collected data from the Machine Preservation Trial, an international randomized controlled trial. 752 Consecutive renal transplants were included: 1 kidney of each of the 376 donors was preserved by HMP, the contralateral organ was preserved by CS...
March 22, 2018: Transplantation
https://www.readbyqxmd.com/read/29566990/preserving-and-perfusing-the-allograft-pancreas-past-present-and-future
#6
REVIEW
Shamik Dholakia, Elisabeth Royston, Edward J Sharples, Visesh Sankaran, Rutger J Ploeg, Peter J Friend
The concept of organ preservation by perfusion dates back to the mid-19th century. Innovations since then have included temperature regulation, perfusion fluid composition and various pumping systems. Advances made in liver, heart and kidney machine preservation are now contributing to increased graft utilisation, assessment of graft viability and potentially improved graft survival. Pancreas transplantation has not benefitted to the same extent from the application of perfusion technology, although the need is just as great...
March 6, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29537102/using-a-kidney-pump-to-perfuse-a-free-filet-flap-for-reconstruction-after-hemipelvectomy-a-case-report
#7
Katharine M Hinchcliff, Jessica Crockett, Steven W Thorpe, Christopher O Bayne
Long ischemia times adversely affect free flap survival, and large muscle flaps are particularly vulnerable. Hypothermic machine perfusion (HMP) is a well-established method of organ preservation, and recent literature has detailed the use of HMP to extend free flap ischemia times, predominantly in the laboratory setting. One limitation in the study and adoption of free flap HMP has been the availability of standardized perfusion machinery, as thus far institutions have built their own devices. We present a case of a 75-year-old woman with dedifferentiated chondrosarcoma of her right proximal femur...
March 14, 2018: Microsurgery
https://www.readbyqxmd.com/read/29493843/renal-resistance-thresholds-during-hypothermic-machine-perfusion-and-transplantation-outcomes-a-retrospective-cohort-study
#8
Shaifali Sandal, Steven Paraskevas, Marcelo Cantarovich, Dana Baran, Prosanto Chaudhury, Jean I Tchervenkov, Ruth Sapir-Pichhadze
Renal resistance (RR), of allografts undergoing hypothermic machine perfusion (HMP), is considered a measure of organ quality. We conducted a retrospective cohort study of adult deceased donor kidney transplant (KT) recipients whose grafts underwent HMP. Our aim was to evaluate whether RR is predictive of death-censored graft failure (DCGF). Of 274 KT eligible for analysis, 59% were from expanded criteria donor. RR was modeled as a categorical variable, using a previously identified terminal threshold of 0...
June 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29474675/machine-perfusion-and-long-term-kidney-transplant-recipient-outcomes-across-allograft-risk-strata
#9
Shaifali Sandal, Xun Luo, Allan B Massie, Steven Paraskevas, Marcelo Cantarovich, Dorry L Segev
Background: The use of machine perfusion (MP) in kidney transplantation lowers delayed graft function (DGF) and improves 1-year graft survival in some, but not all, grafts. These associations have not been explored in grafts stratified by the Kidney Donor Profile index (KDPI). Methods: We analyzed 78 207 deceased-donor recipients using the Scientific Registry of Transplant Recipients data from 2006 to 2013. The cohort was stratified using the standard criteria donor/expanded criteria donor (ECD)/donation after cardiac death (DCD)/donation after brain death (DBD) classification and the KDPI scores...
February 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29434725/a-novel-hypothermic-machine-perfusion-system-using-a-lifeport-kidney-transporter-for-the-preservation-of-rat-liver
#10
Cheng Zeng, Xiaoyan Hu, Yanfeng Wang, Xianpeng Zeng, Yan Xiong, Ling Li, Qifa Ye
The protective mechanisms for liver preservation associated with hypothermic machine perfusion (HMP) remain unclear. However, the lack of a common and portable HMP system for rat livers limits the study of HMP. The present study aimed to develop a novel, modified HMP system using a LifePort Kidney Transporter for preserving rat livers. A simple 'Y' shunt combined with a pressoreceptor for flow and pressure regulation was adapted to perfuse rat livers via the portal vein continuously using a LifePort Kidney Transporter under its 'prime mode' setting...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29407336/perfusion-parameters-of-donation-after-cardiac-death-kidneys-predict-early-transplant-outcomes-based-on-expanded-criteria-donor-designation
#11
Q Tai, W Xue, X Ding, P Tian, H Xiang, X Feng, H Yan, J Hou
BACKGROUND: Donation after cardiac death is the only source of the deceased donor in China at present. Hypothermic machine perfusion has been used increasingly over the years. We determined the hypothermic machine perfusion parameters associated with early transplant outcomes based on the expanded criteria donor (ECD) designation. METHODS: There were 446 consecutive kidneys donated after cardiac death and preserved by hypothermic machine perfusion (LifePort) in our center that were included in this study...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407316/functional-results-of-renal-preservation-in-hypothermic-pulsatile-machine-perfusion-versus-cold-preservation-systematic-review-and-meta-analysis-of-clinical-trials
#12
L Martínez Arcos, J J Fabuel Alcañiz, V Gómez Dos Santos, F J Burgos Revilla
BACKGROUND: Hypothermic pulsatile machine perfusion (HPMP) decreases the rate of delayed graft function (DGF) in kidney grafts, compared with cold storage. However, it is not clear its use in the different subgroups of grafts. The objective was to review systematically all studies with better methodologic quality that compare HPMP versus cold storage. METHODS: A systematic review was performed. The sources were Pubmed, Pubmed Central, Cochrane Library, Clinical Key, and Ovid...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29374912/-selective-preimplantation-pathological-evaluation-in-renal-transplantation-a-single-center-s-experience
#13
F H Peng, J J Chen, L K Peng, X B Xie, G B Lan, S J Yu, Y Wang, X T Tang, H L Dai, C Gao, C H Fang
Objective: To summarize the clinical data of pre-implantation biopsy donors in our hospital and explore the clinical characteristics of those donors in pathological high-risk, and to provide references for the selective histological evaluation of extended criteria donor kidneys. Methods: We retrospectively reviewed the clinical data and pre-implantation renal pathologic score of donors from January 1, 2015 to May 1, 2017.During this period, 247 cases of donation after citizen's death (DCD) occurred.After clinical evaluation and selective machine perfusion( Lifeport) evaluation, 30 cases of pre-implantation pathological evaluation were performed...
January 16, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29342289/recent-advances-in-kidney-transplantation-a-viewpoint-from-the-descartes-advisory-board
#14
Daniel Abramowicz, Rainer Oberbauer, Uwe Heemann, Ondrej Viklicky, Licia Peruzzi, Christophe Mariat, Marta Crespo, Klemens Budde, Gabriel C Oniscu
Transplantation medicine is a rapidly evolving field. Keeping afloat of the published literature to offer the best clinical care to our patients is a daunting task. As part of its educational mission, the Descartes advisory board identified seven topics in kidney transplantation where there has been substantial progresses over the last years: kidney allocation within Eurotransplant; kidney exchange strategies; kidney machine perfusion strategies; the changing landscape of anti-human leukocyte antigen (HLA) antibodies; the new immunosuppressive drugs in the pipeline; strategies for immunosuppression minimization; and the continuous enigma of focal segmental glomerular sclerosis recurrence after transplantation...
January 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29325720/development-of-pancreatic-machine-perfusion-translational-steps-from-porcine-to-human-models
#15
Karim Hamaoui, Sally Gowers, Bynvant Sandhu, Natalie Vallant, Terry Cook, Martyn Boutelle, Daniel Casanova, Vassilios Papalois
BACKGROUND: Hypothermic machine perfusion (HMP) is increasingly being used for extended criteria kidney grafts. Pancreatic HMP is challenging because physiologically the pancreas is a low-flow organ susceptible to edema. We report the successful development of preclinical HMP models using porcine pancreases, as well as human pancreases unsuitable for clinical transplantation. METHODS: Ten porcine pancreases were used in the development of these perfusion models...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29239091/extra-corporeal-normothermic-machine-perfusion-of-the-porcine-kidney-working-towards-future-utilization-in-australasia
#16
Ahmer M Hameed, Ray Miraziz, David B Lu, Neil Warwick, Ali El-Ayoubi, Heather Burns, Yi Vee Chew, Ross Matthews, Greg O'Grady, Lawrence Yuen, Natasha Rogers, Henry C Pleass, Wayne J Hawthorne
BACKGROUND: The ongoing supply-demand gap with respect to donor kidneys for transplantation necessitates the increased use of higher kidney donor profile index and/or donation after circulatory death (DCD) kidneys. Machine perfusion (MP) preservation has become increasingly popular as a means to preserve such organs. Human data regarding normothermic kidney MP (NMP) is in its infancy, and such a system has not been established in the Australasian clinical setting. METHODS: Modified cardio-pulmonary bypass technology was utilized to develop a viable NMP kidney perfusion system using a porcine DCD model...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29217818/proteomic-analysis-of-perfusate-from-machine-cold-perfusion-of-transplant-kidneys-insights-into-protection-from-injury
#17
Michael A J Moser, Katherine Sawicka, Steven Arcand, Preston O'Brien, Patrick Luke, Gavin Beck, Jolanta Sawicka, Alejandro Cohen, Grzegorz Sawicki
BACKGROUND Machine cold perfusion is beneficial to the preservation of kidneys for transplantation. At the end of preservation, the perfusion solution contains many proteins. Using a proteomics approach, we searched for useful biomarkers and potential therapeutic targets in the perfusate. Our program is unique in that all transplant kidneys (even living donor kidneys, LKD) are placed on machine cold perfusion prior to transplantation. MATERIAL AND METHODS Perfusates from donation after neurological and circulatory determination of death (DNDD and DCDD respectively) and LKD were collected (n=41) and analyzed for LDH, neutrophil gelatinase-associated lipocalin (NGAL), and matrix metalloproteinase-2 (MMP-2) as markers of injury...
December 8, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#18
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29187644/nanoparticle-targeting-to-the-endothelium-during-normothermic-machine-perfusion-of-human-kidneys
#19
Gregory T Tietjen, Sarah A Hosgood, Jenna DiRito, Jiajia Cui, Deeksha Deep, Eric Song, Jan R Kraehling, Alexandra S Piotrowski-Daspit, Nancy C Kirkiles-Smith, Rafia Al-Lamki, Sathia Thiru, J Andrew Bradley, Kourosh Saeb-Parsy, John R Bradley, Michael L Nicholson, W Mark Saltzman, Jordan S Pober
Ex vivo normothermic machine perfusion (NMP) is a new clinical strategy to assess and resuscitate organs likely to be declined for transplantation, thereby increasing the number of viable organs available. Short periods of NMP provide a window of opportunity to deliver therapeutics directly to the organ and, in particular, to the vascular endothelial cells (ECs) that constitute the first point of contact with the recipient's immune system. ECs are the primary targets of both ischemia-reperfusion injury and damage from preformed antidonor antibodies, and reduction of perioperative EC injury could have long-term benefits by reducing the intensity of the host's alloimmune response...
November 29, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29174044/repeatability-of-contrast-enhanced-ultrasonography-of-the-kidneys-in-healthy-cats
#20
Emmelie Stock, Luc Duchateau, Jimmy H Saunders, Veerle Volckaert, Ingeborgh Polis, Katrien Vanderperren
Contrast-enhanced ultrasound can be used to image and quantify tissue perfusion. It holds great potential for the use in the diagnosis of various diffuse renal diseases in both human and veterinary medicine. Nevertheless, the technique is known to have an inherent relatively high variability, related to various factors associated with the patient, the contrast agent and machine settings. Therefore, the aim of this study was to assess week-to-week intra- and inter-cat variation of several perfusion parameters obtained with CEUS of both kidneys of 12 healthy cats...
February 2018: Ultrasound in Medicine & Biology
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