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Machine perfusion kidney

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https://www.readbyqxmd.com/read/30218598/algorithms-for-mapping-kidney-tissue-oxygenation-during-normothermic-machine-perfusion-using-hyperspectral-imaging
#1
Wenke Markgraf, Philipp Feistel, Christine Thiele, Hagen Malberg
The lack of donor grafts is a severe problem in transplantation medicine. Hence, the improved preservation of existing and the usage of organs that were deemed untransplantable is as urgent as ever. The development of novel preservation techniques has come into focus. A promising alternative to traditional cold storage is normothermic machine perfusion (NMP), which provides the benefit of improving the organs' viability and of assessing the organs' status under physiological conditions. For this purpose, methods for evaluating organ parameters have yet to be developed...
September 15, 2018: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/30186861/reperfusion-activates-ap-1-and-heat-shock-response-in-donor-kidney-parenchyma-after-warm-ischemia
#2
Alexandr Reznik, Olga Plotnikova, Andrey Skvortsov, Mikhail Skoblov, Oleg Reznik, Ancha Baranova
Utilization of kidneys from extended criteria donors leads to an increase in average warm ischemia time (WIT), which is associated with larger degrees of ischemia-reperfusion injury (IRI). Kidney resuscitation by extracorporeal perfusion in situ allows up to 60 minutes of asystole after the circulatory death. Molecular studies of kidney grafts from human donors with critically expanded WIT are warranted. Transcriptomes of two human kidneys from two different donors were profiled after 35-45 minutes of WIT and after 120 minutes of normothermic perfusion and compared...
2018: BioMed Research International
https://www.readbyqxmd.com/read/30171799/the-effect-on-early-renal-function-of-various-dynamic-preservation-strategies-in-a-preclinical-pig-ischemia-reperfusion-autotransplant-model
#3
T Darius, P Gianello, M Vergauwen, N I Mourad, A Buemi, M De Meyer, M Mourad
The aims of this study were to determine the most optimal timing to start machine perfusion during kidney preservation to improve early graft function and evaluate the impact of temperature and oxygen supply during machine perfusion in a porcine ischemia-reperfusion autotransplant model. The left kidney of a ±40 kg female landrace pig was exposed to 30 minutes of warm ischemia by vascular clamping and randomized to one of 6 study groups: 1) 22hr static cold storage (SCS)(n=6), 2) 22hr hypothermic machine perfusion (HMP)(n=6), 3) 22hr oxygenated HMP(n=7), 4) 20hr HMP + 2hr normothermic perfusion (NP)(n=6), 5) 20hr SCS + 2hr oxygenated HMP(n=7), and 6) 20hr SCS + 2hr NP(n=6)...
September 1, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/30091857/defining-the-optimal-duration-for-normothermic-regional-perfusion-in-the-kidney-donor-a-porcine-preclinical-study
#4
Thomas Kerforne, Geraldine Allain, Sebastien Giraud, Delphine Bon, Virginie Ameteau, Pierre Couturier, William Hebrard, Jerome Danion, Jean-Michel Goujon, Raphael Thuillier, Thierry Hauet, Benoit Barrou, Christophe Jayle
Kidneys from donation after circulatory death (DCD) are highly sensitive to ischemia-reperfusion injury and thus require careful reconditioning, such as Normothermic Regional Perfusion (NRP). However, the optimal NRP protocol remains to be characterized. NRP was modeled in a DCD porcine model (30min of cardiac arrest) for 2h, 4h or 6h compared to a control group (noNRP); kidneys were machine-preserved and allotransplanted. NRP appeared to permit recovery from warm ischemia, possibly due to increased expression of HIF1α-dependent survival pathway...
August 9, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/30085267/the-development-of-a-predictive-model-of-graft-function-in-uncontrolled-donors-after-circulatory-death-validity-of-a-pulsatile-renal-preservation-machine-cut-off-value-for-kidney-acceptance
#5
Rosana Gelpi, David Paredes, Camino Rodríguez-Villar, Rebeca Roque, Angel Ruiz, Ramon Adalia, Luis Peri-Cusí, Manel Sole, Federico Oppenheimer, Fritz Diekmann
Background: The criteria for kidney suitability in uncontrolled donors after circulatory death (uDCD) procured after regional normothermic perfusion are based on macroscopic appearance and renal haemodynamic values with final renal resistance (FRR). However, these criteria have not been analysed to predict the future graft function. This study presents a model to predict the outcome in uDCD kidneys and define the predictive FRR value. Methods: All uDCD kidney transplants performed in our hospital from 2004 to 2016 were included...
August 6, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/30018731/improved-approach-for-normothermic-machine-perfusion-of-cold-stored-kidney-grafts
#6
Charlotte von Horn, Thomas Minor
Normothermic machine perfusion can decrease reperfusion injury in renal transplantation. Clinical procurement logistics include retrieval and initial transport of the graft using static cold storage. Therefore, use and benefits of brief normothermic reconditioning by machine perfusion should be investigated in the initially cold preserved graft. Porcine kidneys (6 per group) were retrieved 20 min after cardiac standstill. After 20 h of static cold preservation some grafts were put on a machine perfusion circuit and normothermically perfused for 2 h at 35°C (NMP)...
2018: American Journal of Translational Research
https://www.readbyqxmd.com/read/29952816/combined-ex-vivo-hypothermic-and-normothermic-perfusion-for-assessment-of-high-risk-deceased-donor-human-kidneys-for-transplantation
#7
Sandra K Kabagambe, Ivonne P Palma, Yulia Smolin, Tristan Boyer, Ivania Palma, Junichiro Sageshima, Christoph Troppmann, Chandrasekar Santhanakrishnan, John P McVicar, Kuang-Yu Jen, Miriam Nuño, Richard V Perez
BACKGROUND: Despite careful clinical examination, procurement biopsy and assessment on hypothermic machine perfusion (HMP), a significant number of potentially useable deceased donor kidneys will be discarded because they are deemed unsuitable for transplantation. Ex vivo normothermic perfusion (EVNP) may be useful as a means to further assess high-risk kidneys to determine suitability for transplantation. METHODS: From June 2014 to October 2015, 7 kidneys (mean donor age 54...
June 27, 2018: Transplantation
https://www.readbyqxmd.com/read/29939277/methylene-blue-treatment-of-grafts-during-cold-ischemia-time-reduces-the-risk-of-hcv-transmission
#8
Fabian A Helfritz, Denisa Bojkova, Verena Wanders, Nina Kuklinski, Sandra Westhaus, Charlotte von Horn, Ursula Rauen, Anja Gallinat, Hideo A Baba, Andreas Skyschally, Sandra Swoboda, Volker Kinast, Eike Steinmann, Gerd Heusch, Thomas Minor, Philip Meuleman, Andreas Paul, Sandra Ciesek
Background: Although organ shortage is a rising problem, organs from HCV RNA positive donors are not routinely transplanted in HCV negative individuals. Since HCV only infects hepatocytes, other organs such as kidneys are merely contaminated with HCV via the blood. We here established a protocol to reduce HCV virions during the cold ischemic time. Material and Methods: Standard virological assays were used to investigate the effect of antivirals, including methylene blue (MB), in different preservation solutions...
June 23, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29929872/hypothermic-machine-perfusion-results-in-a-marginal-kidney-transplant-programme
#9
Victoria Gómez-Dos Santos, Mercedes Ruiz Hernández, Francisco Javier Burgos-Revilla
BACKGROUND: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results. OBJECTIVE: To identify factors impacting HMP in transplantation from marginal donors. DESIGN, SETTING, AND PARTICIPANTS: Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed...
March 2018: European Urology Focus
https://www.readbyqxmd.com/read/29916133/three-dimensional-indices-of-renal-perfusion-in-normal-pregnancy-and-pre-eclampsia
#10
Amanda Ali, Susan Addley, Stephen Ong
INTRODUCTION: We compared renal perfusion in normal pregnant women and women with pre-eclampsia using three-dimensional (3D) ultrasound. We measured the flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which are believed to reflect vascularity and flow intensity. METHODS: Fourteen patients with normal pregnancy and 16 patients with pre-eclampsia were recruited. Imaging was conducted using a Voluson E8 machine and a 6-MHz trans-abdominal probe...
June 18, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29880384/perfusion-of-a-kidney-graft-from-a-donor-after-cardiac-death-based-on-immediately-started-pulsatile-machine-perfusion-an-experimental-study-on-a-small-animal
#11
V Opatrný, J Moláček, V Třeška, R Matějka, O Hes
INTRODUCTION: There is still a lack of organs for kidney transplantation. The aim of our experimental animal study was to improve the quality of the kidney grafts from donors after cardiac death (DCD) using immediate start of machine perfusion instead of perfusion based on hydrostatic pressure. METHODS: Ten rabbits were used as an experimental model. In group A, 5 kidneys after ischemic injury were perfused in situ using hydrostatic pressure. In group B, 5 kidneys were perfused in situ using machine pulsatile perfusion...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29878499/the-future-of-marginal-kidney-repair-in-the-context-of-normothermic-machine-perfusion
#12
REVIEW
Jenna R DiRito, Sarah A Hosgood, Gregory T Tietjen, Michael L Nicholson
Normothermic machine perfusion (NMP) is a technique that utilizes extracorporeal membrane oxygenation to recondition and repair kidneys at near body temperature prior to transplantation. The application of this new technology has been fueled by a significant increase in the use of the kidneys that were donated after cardiac death, which are more susceptible to ischemic injury. Preliminary results indicate that NMP itself may be able to repair marginal organs prior to transplantation. In addition, NMP serves as a platform for delivery of therapeutics...
June 7, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29792716/options-to-improve-the-quality-of-kidney-grafts-from-expanded-criteria-donors-experimental-study
#13
J Molacek, V Opatrný, V Treska, R Matejka, O Hes
INTRODUCTION: There is a worldwide discrepancy between the number of donors and the number of organs needed for transplantation, leading to certain expansion of criteria, resulting in acceptance of donor organs. This means that organs with worse parenchymal qualities may be harvested for transplantation. One possibility, how to ameliorate the quality of these organs, is to change the concept of their preservation during cold ischemia or even after sudden circulatory arrest, prior to the collection of the organ itself...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29758129/twenty-four-hour-normothermic-perfusion-of-discarded-human-kidneys-with-urine-recirculation
#14
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 use, and improved transplant logistics. Eleven clinically declined kidneys were perfused normothermically, with 6 being from donors after brain death (median cold ischemia time 33 ± 36.9 hours) and 5 being from donors after circulatory death (36.2 ± 38.3 hours). Three kidneys were perfused using Ringer's lactate to replace excreted urine volume, and 8 kidneys were perfused 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
#15
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...
June 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29607529/transplantation-of-cold-stored-porcine-kidneys-after-controlled-oxygenated-rewarming
#16
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...
June 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
#17
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...
July 2018: Artificial Organs
https://www.readbyqxmd.com/read/29570164/the-benefits-of-hypothermic-machine-preservation-and-short-cold-ischemia-times-in-deceased-donor-kidneys
#18
Jasper Kox, Cyril Moers, Diethard Monbaliu, Agita Strelniece, Jürgen Treckmann, Ina Jochmans, Henri Leuvenink, Ernest Van Heurn, Jacques Pirenne, Andreas Paul, Rutger 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 analyzed prospectively collected data from the Machine Preservation Trial, an international randomized controlled trial. Seven hundred fifty-two consecutive renal transplants were included: 1 kidney of each of the 376 donors was preserved by HMP, the contralateral organ was preserved by CS...
August 2018: Transplantation
https://www.readbyqxmd.com/read/29566990/preserving-and-perfusing-the-allograft-pancreas-past-present-and-future
#19
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...
July 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
#20
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
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