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normothermic machine perfusion

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https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#1
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28805266/hypothermic-pulsatile-preservation-of-kidneys-from-uncontrolled-deceased-donors-after-cardiac-arrest
#2
Xavier Matillon, Fabrice Danjou, Palmina Petruzzo, Olivier Thaunat, Thomas Rimmele, Claire Delsuc, Alexandre Faure, Maud Rabeyrin, Vannary Meas Yedid, William Hanf, Emmanuel Morelon, Lionel Badet, Ricardo Codas
Kidneys from uncontrolled donors after cardiac arrest (uDCD) suffer from a period of warm ischemia between cardiac arrest and cold flushing. Aim of the study was to evaluate renal outcomes of uDCD kidneys selected on the basis of renal Resistance Index (RI) and its influence on graft function and survival. The study included 44 kidneys procured from 26 uDCD starting 1.1.2006 until 31.12.2013. The donors (Maastricht category II) underwent cardiopulmonary resuscitation by assisted ventilation and chest compression; the organs were preserved with "in situ" cold perfusion or a normothermic regional perfusion...
August 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28775323/ex-vivo-pretreatment-of-human-vessels-with-sirna-nanoparticles-provides-protein-silencing-in-endothelial-cells
#3
Jiajia Cui, Lingfeng Qin, Junwei Zhang, Parwiz Abrahimi, Hong Li, Guangxin Li, Gregory T Tietjen, George Tellides, Jordan S Pober, W Mark Saltzman
Human endothelial cells are initiators and targets of the rejection response. Pre-operative modification of endothelial cells by small interfering RNA transfection could shape the nature of the host response post-transplantation. Ablation of endothelial cell class II major histocompatibility complex molecules by small interfering RNA targeting of class II transactivator can reduce the capacity of human endothelial cells to recruit and activate alloreactive T cells. Here, we report the development of small interfering RNA-releasing poly(amine-co-ester) nanoparticles, distinguished by their high content of a hydrophobic lactone...
August 4, 2017: Nature Communications
https://www.readbyqxmd.com/read/28624105/hypo-and-normothermic-perfusion-of-the-liver-which-way-to-go
#4
REVIEW
Jasmijn Selten, Andrea Schlegel, Jeroen de Jonge, Philipp Dutkowski
The demand of donor livers for transplantation exceeds the supply. In an attempt to maximize the number of potentially usable donor livers, several centers are exploring the role of machine perfusion. This review provides an update on machine perfusion strategies and basic concepts, based on current clinical issues, and discuss challenges, including currently used biomarkers for assessing the quality and viability of perfused organs. The potential benefits of machine perfusion on immunogenicity and the consequences on post-operative immunosuppression management are discussed...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28557562/mesenchymal-stromal-cells-as-anti-inflammatory-and-regenerative-mediators-for-donor-kidneys-during-normothermic-machine-perfusion
#5
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...
August 15, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/28520579/the-use-of-an-acellular-oxygen-carrier-in-a-human-liver-model-of-normothermic-machine-perfusion
#6
Richard W Laing, Ricky H Bhogal, Lorraine Wallace, Yuri Boteon, Desley A H Neil, Amanda Smith, Barney T F Stephenson, Andrea Schlegel, Stefan G Hübscher, Darius F Mirza, Simon C Afford, Hynek Mergental
BACKGROUND: Normothermic machine perfusion of the liver (NMP-L) is a novel technique that preserves liver grafts under near-physiological conditions whilst maintaining their normal metabolic activity. This process requires an adequate oxygen supply, typically delivered by packed red blood cells (RBC). We present the first experience using an acellular hemoglobin-based oxygen carrier (HBOC) Hemopure in a human model of NMP-L. METHODS: Five discarded high-risk human livers were perfused with HBOC-based perfusion fluid and matched to 5 RBC-perfused livers...
May 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28483273/ex-vivo-machine-perfusion-for-renal-graft-preservation
#7
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
#8
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
#9
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/28426449/temperature-and-oxygenation-during-organ-preservation-friends-or-foes
#10
Nicholas Gilbo, Diethard Monbaliu
PURPOSE OF REVIEW: The liberalization of donor selection criteria in organ transplantation, with the increased use of suboptimal grafts, has stimulated interest in ischemia-reperfusion injury prevention and graft reconditioning. Organ preservation technologies are changing considerably, mostly through the reintroduction of dynamic machine preservation. Here, we review the current evidence on the role of temperature and oxygenation during dynamic machine preservation. RECENT FINDINGS: A large but complex body of evidence exists and comparative studies are few...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28390094/early-experience-with-hypothermic-machine-perfusion-of-living-donor-kidneys-a-retrospective-study
#11
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/28351756/oxygenated-hypothermic-machine-perfusion-after-static-cold-storage-improves-endothelial-function-of-extended-criteria-donor-livers
#12
Laura C Burlage, Negin Karimian, Andrie C Westerkamp, Nienke Visser, Alix P M Matton, Rianne van Rijn, Jelle Adelmeijer, Janneke Wiersema-Buist, Annette S H Gouw, Ton Lisman, Robert J Porte
BACKGROUND: Lack of oxygen and biomechanical stimulation during static cold storage (SCS) of donor livers compromises endothelial cell function. We investigated the effect of end-ischemic oxygenated hypothermic machine perfusion (HMP) on endothelial cell function of extended criteria donor (ECD) livers. METHODS: Eighteen livers, declined for transplantation, were transported to our center using static cold storage (SCS). After SCS, 6 livers underwent two hours of HMP, and subsequent normothermic machine perfusion (NMP) to assess viability...
June 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28333889/normothermic-ex-situ-liver-preservation-the-new-gold-standard
#13
Richard W Laing, Hynek Mergental, Darius F Mirza
PURPOSE OF REVIEW: Normothermic machine perfusion of the liver (NMP-L) is a novel technology recently introduced into the practice of liver transplantation. This review recapitulates benefits of normothermic perfusion over conventional static cold storage and summarizes recent publications in this area. RECENT FINDINGS: The first clinical trials have demonstrated both safety and feasibility of NMP-L. They have shown that machine perfusion can entirely replace cold storage or be commenced following a period of cold ischaemia...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28301388/cold-storage-or-normothermic-perfusion-for-liver-transplantation-probable-application-and-indications
#14
Carlo D L Ceresa, David Nasralla, Simon Knight, Peter J Friend
PURPOSE OF REVIEW: Preservation of the liver via normothermic machine perfusion (NMP) is rapidly becoming an area of great academic and clinical interest. This review focuses on the benefits and limitations of NMP and where the role for static cold storage may lie. RECENT FINDINGS: Clinical studies have recently been published reporting the use of NMP in liver preservation for transplantation. They have described the technology to be well tolerated and feasible with potentially improved posttransplant outcomes...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28301386/kidney-perfusion-some-like-it-hot-others-prefer-to-keep-it-cool
#15
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/28240817/liver-ex-situ-machine-perfusion-preservation-a-review-of-the-methodology-and-results-of-large-animal-studies-and-clinical-trials
#16
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/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
#17
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/27941468/liver-perfusion-devices-how-close-are-we-to-widespread-application
#18
Amelia J Hessheimer, Constantino Fondevila
PURPOSE OF REVIEW: Ex-situ liver machine perfusion has been the focus of increasing interest over the past decade as a means to improve the quality of livers for transplantation and the applicability of liver transplantation in general. The present review aims to evaluate the experimental basis for liver machine perfusion and the significance of recent reports on its clinical application. RECENT FINDINGS: Although liver machine perfusion has been studied experimentally over a range of temperatures, clinical liver transplant work that has been performed to date has been done using either hypothermic machine perfusion (0-12 °C), HMP or normothermic machine perfusion (35-38 °C, NMP)...
December 9, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27941437/activation-of-fibrinolysis-but-not-coagulation-during-end-ischemic-ex-situ-normothermic-machine-perfusion-of-human-donor-livers
#19
Shanice A Karangwa, Laura C Burlage, Jelle Adelmeijer, Negin Karimian, Andrie C Westerkamp, Alix P Matton, Rianne van Rijn, Janneke Wiersema-Buist, Micheal E Sutton, Sanna Op den Dries, Ton Lisman, Robert J Porte
BACKGROUND: Ex situ normothermic machine perfusion (NMP) can be performed after traditional static cold preservation to assess graft function and viability before transplantation. It is unknown whether this results in activation of coagulation and fibrinolysis, as may occur upon graft reperfusion in vivo. METHODS: Twelve donor livers declined for transplantation underwent 6 hours of end-ischemic NMP using a heparinized plasma-based perfusion fluid. Concentration of prothrombin fragment F1 + 2 (marker of coagulation activation), D-dimer, plasmin-antiplasmin complex, tissue plasminogen activator and plasminogen activator inhibitor-1 (markers for fibrinolysis) and alanine aminotransferase (ALT) (marker of ischemia-reperfusion [I/R] injury) were measured in perfusion fluid at regular intervals...
February 2017: Transplantation
https://www.readbyqxmd.com/read/27870928/mir-182-5p-inhibition-ameliorates-ischemic-acute-kidney-injury
#20
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
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