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Machine perfusion kidney

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https://www.readbyqxmd.com/read/28639291/perfusion-of-isolated-rat-kidney-with-mesenchymal-stromal-cells-extracellular-vesicles-prevents-ischaemic-injury
#1
Marilena Gregorini, Valeria Corradetti, Eleonora Francesca Pattonieri, Chiara Rocca, Samantha Milanesi, Andrea Peloso, Silvana Canevari, Loris De Cecco, Matteo Dugo, Maria Antonietta Avanzini, Melissa Mantelli, Marcello Maestri, Pasquale Esposito, Stefania Bruno, Carmelo Libetta, Antonio Dal Canton, Teresa Rampino
Kidney donation after circulatory death (DCD) is a less than ideal option to meet organ shortages. Hypothermic machine perfusion (HMP) with Belzer solution (BS) improves the viability of DCD kidneys, although the graft clinical course remains critical. Mesenchymal stromal cells (MSC) promote tissue repair by releasing extracellular vesicles (EV). We evaluated whether delivering MSC-/MSC-derived EV during HMP protects rat DCD kidneys from ischaemic injury and investigated the underlying pathogenic mechanisms...
June 21, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28573190/randomized-trial-of-machine-perfusion-versus-cold-storage-in-recipients-of-deceased-donor-kidney-transplants-with-high-incidence-of-delayed-graft-function
#2
Helio Tedesco-Silva, Juliano Chrystian Mello Offerni, Vanessa Ayres Carneiro, Mayara Ivani de Paula, Elias David Neto, Francine Brambate Carvalhinho Lemos, Lúcio Roberto Requião Moura, Alvaro Pacheco E Silva Filho, Mirian de Fátima de Morais Cunha, Erica Francisco da Silva, Luiz Antonio Miorin, Daniela Priscila Demetrio, Paulo Sérgio Luconi, Waldere Tania da Silva Luconi, Savina Adriana Bobbio, Liz Milstein Kuschnaroff, Irene Lourdes Noronha, Sibele Lessa Braga, Renata Cristina Barsante, João Cezar Mendes Moreira, Ida Maria Maximina Fernandes-Charpiot, Mario Abbud-Filho, Luis Gustavo Modelli de Andrade, Paula Dalsoglio Garcia, Luciana Tanajura Santamaria Saber, Alan Fernandes Laurindo, Pedro Renato Chocair, Américo Lourenço Cuvello Neto, Juliana Aparecida Zanocco, Antonio Jose Duboc de Almeida Soares Filho, Wilson Ferreira Aguiar, Jose Medina Pestana
BACKGROUND: This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). METHODS: In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF...
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28571996/the-effect-of-the-use-of-a-tnf-alpha-inhibitor-in-hypothermic-machine-perfusion-on-kidney-function-after-transplantation
#3
Piotr Diuwe, Piotr Domagala, Magdalena Durlik, Janusz Trzebicki, Andrzej Chmura, Artur Kwiatkowski
One of the most important problems in transplantation medicine is the ischemia/reperfusion injury of the organs to be transplanted. The aim of the present study was to assess the effect of tumor necrosis factor-alpha (TNF-alpha) inhibitor etanercept on the machine perfusion hypothermia of renal allograft kidney function and organ perfusion. No statistically significant differences were found in the impact of the applied intervention on kidney machine perfusion during which the average flow and vascular resistance were evaluated...
May 29, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28557562/mesenchymal-stromal-cells-as-anti-inflammatory-and-regenerative-mediators-for-donor-kidneys-during-normothermic-machine-perfusion
#4
Jesus Maria Sierra-Parraga, Marco Eijken, James Hunter, Cyril Moers, Henri Leuvenink, Bjarne Møller, Rutger J Ploeg, Carla C Baan, Bente Jespersen, Martin J Hoogduijn
There is great demand for transplant kidneys for the treatment of end-stage kidney disease patients. To expand the donor pool, organs from older and comorbid brain death donors, so-called expanded criteria donors (ECD), as well as donation after circulatory death donors, are considered for transplantation. However, the quality of these organs may be inferior to standard donor organs. A major issue affecting graft function and survival is ischemia/reperfusion injury, which particularly affects kidneys from deceased donors...
June 26, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/28483273/ex-vivo-machine-perfusion-for-renal-graft-preservation
#5
REVIEW
J Moritz Kaths, Andreas Paul, Lisa A Robinson, Markus Selzner
Kidney transplantation is the treatment of choice for end-stage renal disease. Despite its superiority over dialysis, the persisting organ shortage remains a major drawback. Additional sources to increase the donor pool are grafts recovered from extended criteria donors (ECD) and donation after circulatory death (DCD). Although transplantation of marginal grafts demonstrates promising outcomes, increased rates of primary non-function, delayed graft function, and reduced graft survival have been reported. Cold ischemic injury, caused by static cold storage is a significant risk factor for poor outcome...
April 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28457385/blood-lactate-concentrations-before-and-after-withdrawal-of-life-sustaining-treatments-in-controlled-donation-after-circulatory-death-a-case-report-from-italy
#6
F Baroncelli, M C Alberione, V Cacciotti, D Artusio, M Vergano, S Livigni
A 20-minute hands-off period with isoelectric electrocardiography (ECG) monitoring is currently required for the declaration of cardiac death in Italy, thus prolonging the warm ischemia time (WIT) during donation after circulatory death (DCD). Normothermic regional perfusion (NRP) can be a valid tool to optimize organ perfusion as a bridge to donation. A 62-year-old woman with catastrophic brain injury due to massive intracranial hemorrage, not fulfilling brain death criteria, underwent controlled DCD after withdrawal of life-sustaining therapies (WLST)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457381/salvage-of-an-octogenarian-liver-graft-using-normothermic-perfusion-a-case-report
#7
D Pezzati, D Ghinolfi, E Balzano, P De Simone, L Coletti, N Roffi, E Rreka, L Meacci, D Campani, A Mazzoni, A Paolicchi, L Caponi, P Marchetti, L Marselli, F Filipponi
Liver transplantation with very old donors is safe, but is associated with an increased incidence of ischemic-type biliary lesions and delayed graft function. Normothermic machine perfusion (NMP) is a novel technique for preservation of liver grafts and has the potential to reduce ischemia-reperfusion injury. A case is reported here of a liver transplantation (LT) with a graft from an 83-year-old brain-dead donor. Procurement was with dual perfusion and en bloc, modified fast technique. Donor kidneys were not transplanted due to severe atherosclerosis and poor perfusion...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28398965/a-novel-approach-in-combined-liver-and-kidney-transplantation-with-long-term-outcomes
#8
COMPARATIVE STUDY
Burcin Ekser, Richard S Mangus, W Fridell, Chandrashekhar A Kubal, Shunji Nagai, Sandra B Kinsella, Demetria R Bayt, Teresa M Bell, John A Powelson, William C Goggins, A Joseph Tector
OBJECTIVE: The aim of this study was to compare the outcomes of simultaneous and delayed implantation of kidney grafts in combined liver-kidney transplantation (CLKT). BACKGROUND DATA: Delayed function of the renal graft (DGF), which can result from hypotension and pressor use related to the liver transplantation (LT), may cause worse outcomes in CLKT. METHODS: A total of 130 CLKTs were performed at Indiana University between 2002 and 2015 and studied in an observational cohort study...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28390094/early-experience-with-hypothermic-machine-perfusion-of-living-donor-kidneys-a-retrospective-study
#9
Michael A J Moser, Nathan Ginther, Yigang Luo, Gavin Beck, Ronn Ginther, Marla Ewen, Rhianna Matsche-Neufeld, Ahmed Shoker, Grzegorz Sawicki
Although hypothermic machine perfusion (HMP) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on living donor kidneys (LDK) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage (SCS). Outcomes of interest are resistive indices (RI), both while on HMP and postoperatively, and creatinine clearance (CrCl). Injury markers NGAL and LDH were seen in the perfusate of LDK in amounts similar to what is found for donation after neurological determination of death kidneys...
July 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28357590/non-machinery-dialysis-that-achieves-blood-purification-therapy-without-using-full-scale-dialysis-machines
#10
Takaya Abe, Mistutaka Onoda, Tomohiko Matsuura, Jun Sugimura, Wataru Obara, Toshiya Sato, Mihoko Takahashi, Kenta Chiba, Tomiya Abe
An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury...
March 29, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28301386/kidney-perfusion-some-like-it-hot-others-prefer-to-keep-it-cool
#11
Ina Jochmans, Michael L Nicholson, Sarah A Hosgood
PURPOSE OF REVIEW: Machine perfusion technologies provide an opportunity for improved preservation, organ assessment, and resuscitation of damaged kidneys. This review summarizes the recent advances in hypothermic and normothermic kidney machine perfusion technologies. RECENT FINDINGS: Modifications to the perfusion conditions with the addition of oxygen during hypothermic machine perfusion can support a low level of metabolism, which in experimental settings improves graft function...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28266940/role-of-temperature-in-reconditioning-and-evaluation-of-cold-preserved-kidney-and-liver-grafts
#12
Thomas Minor, Charlotte von Horn, Andreas Paul
PURPOSE OF REVIEW: Organ shortage in transplantation medicine forces surgical research toward the development of more efficient approaches in organ preservation to enable the application of 'less than optimal' grafts. This review summarizes current techniques aiming to recondition cold-stored organ grafts prior to transplantation to reduce reperfusion-induced tissue injury and improve postimplantation graft function. RECENT FINDINGS: End-ischemic reconditioning has classically been attempted by cold oxygenated perfusion...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#13
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28240817/liver-ex-situ-machine-perfusion-preservation-a-review-of-the-methodology-and-results-of-large-animal-studies-and-clinical-trials
#14
REVIEW
Hazel Marecki, Adel Bozorgzadeh, Robert J Porte, Henri G Leuvenink, Korkut Uygun, Paulo N Martins
Ex vivo machine perfusion (MP) is a promising way to better preserve livers prior to transplantation. Currently, no methodology has a verified benefit over simple cold storage. Before becoming clinically feasible, MP requires validation in models that reliably predict human performance. Such a model has been found in porcine liver, whose physiological, anatomical, and immunological characteristics closely resemble the human liver. Since the 1930s, researchers have explored MP as preservation, but only recently have clinical trials been performed...
May 2017: Liver Transplantation
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
#15
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
#16
REVIEW
María José Pérez-Sáez, Núria 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 or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
April 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
#17
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
#18
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
#19
COMPARATIVE STUDY
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
#20
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
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