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Machine perfusion renal

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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/28571996/the-effect-of-the-use-of-a-tnf-alpha-inhibitor-in-hypothermic-machine-perfusion-on-kidney-function-after-transplantation
#2
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/28483273/ex-vivo-machine-perfusion-for-renal-graft-preservation
#3
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/28398965/a-novel-approach-in-combined-liver-and-kidney-transplantation-with-long-term-outcomes
#4
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/28357590/non-machinery-dialysis-that-achieves-blood-purification-therapy-without-using-full-scale-dialysis-machines
#5
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/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#6
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/27870928/mir-182-5p-inhibition-ameliorates-ischemic-acute-kidney-injury
#7
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
#8
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
#9
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/27718228/prediction-of-renal-function-upon-reperfusion-by-ex-situ-controlled-oxygenated-rewarming
#10
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
#11
REVIEW
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/27556029/beneficial-effect-of-short-pretransplant-period-of-hypothermic-pulsatile-perfusion-of-the-warm-ischemic-kidney-after-cold-storage-experimental-study
#12
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/27495754/organ-pretreatment-with-cytotopic-endothelial-localising-peptides-to-ameliorate-microvascular-thrombosis-perfusion-deficits-in-ex-vivo-renal-haemo-reperfusion-models
#13
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
https://www.readbyqxmd.com/read/27490874/advances-in-organ-preservation-for-transplantation
#14
Ahmer M Hameed, Wayne J Hawthorne, Henry C Pleass
Organ transplantation provides the best available therapy for a myriad of medical conditions, including end-stage renal disease, hepatic failure and type I diabetes mellitus. The current clinical reality is, however, that there is a significant shortage of organs available for transplantation with respect to the number of patients on organ waiting lists. As such, methods to increase organ supply have been instituted, including improved donor management, organ procurement and preservation strategies, living organ donation, transplantation education and the increased utilization of donation after circulatory death and expanded criteria donors...
August 4, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27421771/negative-impact-of-prolonged-cold-storage-time-before-machine-perfusion-preservation-in-donation-after-circulatory-death-kidney-transplantation
#15
Siegfredo Paloyo, Junichiro Sageshima, Jeffrey J Gaynor, Linda Chen, Gaetano Ciancio, George W Burke
Kidney grafts are often preserved initially in static cold storage (CS) and subsequently on hypothermic machine perfusion (MP). However, the impact of CS/MP time on transplant outcome remains unclear. We evaluated the effect of prolonged CS/MP time in a single-center retrospective cohort of 59 donation after circulatory death (DCD) and 177 matched donation after brain death (DBD) kidney-alone transplant recipients. With mean overall CS/MP times of 6.0 h/30.0 h, overall incidence of delayed graft function (DGF) was higher in DCD transplants (30...
October 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27273794/successful-transplantation-of-human-kidneys-deemed-untransplantable-but-resuscitated-by-ex-vivo-normothermic-machine-perfusion
#16
S A Hosgood, K Saeb-Parsy, M O Hamed, M L Nicholson
We report the successful transplantation of a pair of human kidneys that were declined for transplantation due to inadequate in situ perfusion but subsequently transplanted after perfusion and assessment using ex vivo normothermic perfusion (EVNP). The kidneys were from a 35-year-old man, a donation after circulatory death donor. Both kidneys were declined by all UK transplant centers. On arrival, the kidneys had significant areas of incomplete clearance of blood from the microcirculation that did not clear after a further attempt to flush them...
November 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27177159/hypothermic-machine-perfusion-increases-a20-expression-which-protects-renal-cells-against-ischemia-reperfusion-injury-by-suppressing-inflammation-apoptosis-and-necroptosis
#17
Zixuan Yang, Zibiao Zhong, Mingxia Li, Yan Xiong, Yanfeng Wang, Guizhu Peng, Qifa Ye
There is an urgent need to improve the quality of donor organs obtained after cardiac death. In the present study, we examined the potential mechanisms through which A20 protects renal cells against ischemia/reperfusion injury (IRI) following either hypothermic machine perfusion (HMP) or static cold storage (CS) of the kidneys in a rabbit model. The expression of markers of apoptosis, necroptosis and inflammation in frozen kidney tissues were detected by western blot analysis, RT-qPCR and ELISA. Compared with the CS group, A20 expression was significantly higher in the tissue from the HMP group (P<0...
July 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/27160678/capsulotomy-of-ischemically-damaged-donor-kidneys-a-pig-study
#18
Tim C van Smaalen, Moniek G A M Mestrom, Jasper J H F M Kox, Bjorn Winkens, L W Ernest van Heurn
BACKGROUND: Ischemia-reperfusion injury of donor kidneys may worsen transplant outcome. Kidneys with severe injury, such as kidneys of donors after circulatory death, develop edema, which may lead to renal compartment syndrome with reduced tissue perfusion. OBJECTIVE: We studied the effect of capsulotomy during hypothermic machine perfusion (HMP) of ischemically damaged porcine kidneys. METHODS: Eight pairs of kidneys from slaughterhouse pigs were assigned to two groups (20 and 45 min of warm ischemia)...
2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/27097986/mechanisms-of-hypothermic-machine-perfusion-to-decrease-donation-after-cardiac-death-graft-inflammation-through-the-pathway-of-upregulating-expression-of-klf2-and-inhibiting-tgf-%C3%AE-signaling
#19
Zhongzhong Liu, Zibiao Zhong, Jianan Lan, Mingxia Li, Wei Wang, Jing Yang, Chenwei Tang, Jie Wang, Shaojun Ye, Yan Xiong, Yanfeng Wang, Qifa Ye
Hypothermic machine perfusion (HMP) has been known as an efficient way to improve kidney graft function, but the underlying mechanisms remain unclear. Here, we adopt a rabbit reperfusion mode to investigate the upstream mechanisms of end-ischemic HMP of kidneys from donors after cardiac death (DCD), with static cold storage (CS) as a control. Eighteen New Zealand healthy male rabbits (12 weeks old, with a weight of 3.0 ± 0.2 kg) were randomly divided into three groups: HMP group, CS group, and Normal group (n = 6)...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/27070724/comparison-of-aerobic-preservation-by-venous-systemic-oxygen-persufflation-or-oxygenated-machine-perfusion-of-warm-ischemia-damaged-porcine-kidneys
#20
COMPARATIVE STUDY
Julia Kalenski, Elina Mancina, Pascal Paschenda, Christian Beckers, Christian Bleilevens, Ľubomíra Tóthová, Peter Boor, Dominik Gross, René H Tolba, Benedict M Doorschodt
BACKGROUND/AIM: The global shortage of donor organs for transplantation has necessitated the expansion of the organ pool through increased use of organs from less ideal donors. Venous systemic oxygen persufflation (VSOP) and oxygenated machine perfusion (OMP) have previously demonstrated beneficial results compared to cold storage (CS) in the preservation of warm-ischemia-damaged kidney grafts. The aim of this study was to compare the efficacy of VSOP and OMP for the preservation of warm-ischemia-damaged porcine kidneys using the recently introduced Ecosol preservation solution compared to CS using Ecosol or histidine-tryptophan-ketoglutarate solution (HTK)...
2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
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