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hypothermic machine perfusion

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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
#1
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
#2
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/29564206/hypothermic-machine-preservation-of-the-liver-state-of-the-art
#3
REVIEW
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
Purpose of Review: In this review, we highlight which livers may benefit from additional treatment before implantation and describe the concept of hypothermic machine liver perfusion. Furthermore, we explain why cold oxygenated perfusion concepts could potentially lead to a breakthrough in this challenging field of transplantation. Accordingly, we summarize recent clinical applications of different hypothermic perfusion approaches. Recent Findings: The impact of end-ischemic, hypothermic liver perfusion in liver transplantation is currently assessed by two multicenter, randomized controlled trials...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29564205/from-gut-feeling-to-objectivity-machine-preservation-of-the-liver-as-a-tool-to-assess-organ-viability
#4
REVIEW
Christopher J E Watson, Ina Jochmans
Purpose of Review: The purpose of this review was to summarise how machine perfusion could contribute to viability assessment of donor livers. Recent Findings: In both hypothermic and normothermic machine perfusion, perfusate transaminase measurement has allowed pretransplant assessment of hepatocellular damage. Hypothermic perfusion permits transplantation of marginal grafts but as yet has not permitted formal viability assessment. Livers undergoing normothermic perfusion have been investigated using parameters similar to those used to evaluate the liver in vivo...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29537102/using-a-kidney-pump-to-perfuse-a-free-filet-flap-for-reconstruction-after-hemipelvectomy-a-case-report
#5
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
#6
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 ECD. RR was modeled as a categorical variable, using a previously identified terminal threshold of 0.4, and 0.2 mmHg/mL/min (median in our cohort)...
March 1, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29434725/a-novel-hypothermic-machine-perfusion-system-using-a-lifeport-kidney-transporter-for-the-preservation-of-rat-liver
#7
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
#8
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
#9
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/29369470/hypothermic-oxygenated-machine-perfusion-reduces-bile-duct-reperfusion-injury-after-transplantation-of-donation-after-circulatory-death-livers
#10
Rianne van Rijn, Otto B van Leeuwen, Alix P M Matton, Laura C Burlage, Janneke Wiersema-Buist, Marius C van den Heuvel, Ruben H J de Kleine, Marieke T de Boer, Annette S H Gouw, Robert J Porte
INTRODUCTION: Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia-reperfusion injury. This study aimed to determine whether DHOPE reduces IR injury of the bile ducts in DCD liver transplantation. MATERIALS AND METHODS: In a recently performed phase 1-trial, ten DCD livers were preserved with DHOPE after static cold storage (SCS) (www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient...
January 25, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29325720/development-of-pancreatic-machine-perfusion-translational-steps-from-porcine-to-human-models
#11
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/29278454/hypothermic-machine-perfusion-in-liver-transplantation
#12
R Cutler Quillin, James V Guarrera
A finite supply of donor organs has led many transplant centers to accept marginal liver allografts with increasing frequency. These allografts may be at higher risk of primary nonfunction, early allograft dysfunction, and other recipient complications following liver transplantation. Machine perfusion preservation is an emerging technology that limits ischemia/reperfusion injury associated with preservation and may lead to improved outcomes following transplantation. Increased used of machine perfusion in liver preservation may permit an expansion of the donor pool...
February 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29142469/hypothermic-machine-perfusion-with-metformin-university-of-wisconsin-solution-for-ex-viv-o-preservation-of-standard-and-marginal-liver-grafts-in-a-rat-model
#13
Yi-Chao Chai, Guo-Xin Dang, Hai-Qi He, Jian-Hua Shi, Hong-Ke Zhang, Rui-Tao Zhang, Bo Wang, Liang-Shuo Hu, Yi Lv
AIM: To compare the effect of University of Wisconsin (UW) solution with or without metformin, an AMP-activated protein kinase (AMPK) activator, for preserving standard and marginal liver grafts of young and aged rats ex vivo by hypothermic machine perfusion (HMP). METHODS: Eighteen young (4 mo old) and 18 aged (17 mo old) healthy male SD rats were selected and randomly divided into three groups: control group, UW solution perfusion group (UWP), and UW solution with metformin perfusion group (MUWP)...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29136348/outcomes-of-donation-after-circulatory-death-kidneys-undergoing-hypothermic-machine-perfusion-following-static-cold-storage-a-uk-population-based-cohort-study
#14
Kamlesh Patel, Jay Nath, James Hodson, Nicholas Inston, Andrew Ready
Evidence is currently lacking regarding the outcomes of kidneys undergoing hypothermic machine perfusion (HMP) in patients in the United Kingdom. Using the National Health Service Blood and Transplant database, the authors compared outcomes for recipients of single-organ donation after circulatory death (DCD) kidneys preserved with HMP with those preserved using only static cold storage (SCS). Between 2007 and 2015, HMP was used in 19.1% (864/4,529) of kidneys. Rates of delayed graft function (DGF) were significantly lower in organs preserved with HMP than for organs preserved with SCS (34...
November 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29108514/hypothermic-oxygenated-machine-perfusion-for-liver-transplantation-an-initial-experience
#15
Damiano Patrono, Bruna Lavezzo, Luca Molinaro, Giorgia Rizza, Giorgia Catalano, Federica Gonella, Mauro Salizzoni, Renato Romagnoli
OBJECTIVES: Due to widespread exploitation of extended criteria donors, machine perfusion is emerging as an alternative to static cold storage for organ preservation. Hypothermic oxygenated machine perfusion has been associated with improved outcomes after liver transplant, both in laboratory and clinical settings. Here, we present our initial experience with hypothermic oxygenated machine perfusion, evaluating incidence of postreperfusion syndrome, early allograft dysfunction, and long-term biliary complications...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29039506/hypothermic-machine-perfusion-ameliorates-inflammation-during-ischemia%C3%A2-reperfusion-injury-via-sirtuin%C3%A2-1%C3%A2-mediated-deacetylation-of-nuclear-factor%C3%A2-%C3%AE%C2%BAb-p65-in-rat-livers-donated-after-circulatory-death
#16
Cheng Zeng, Xiaoyan Hu, Weiyang He, Yanfeng Wang, Ling Li, Yan Xiong, Qifa Ye
Hypothermic machine perfusion (HMP) effectively reduces ischemia‑reperfusion injury (IRI) in livers donated after circulatory death (DCD) when compared with cold storage (CS). However, the underlying mechanisms remain unclear. The current study aimed to investigate the cellular mechanisms by which HMP ameliorates the inflammatory response during IRI. Adult male Sprague‑Dawley rat livers were exposed to 30 min of warm ischemia following cardiac arrest and preserved by CS or HMP for 3 h (n=3 per group)...
December 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29023512/the-ultrastructural-characteristics-of-porcine-hepatocytes-donated-after-cardiac-death-and-preserved-with-warm-machine-perfusion-preservation
#17
Hiroki Bochimoto, Naoto Matsuno, Yo Ishihara, Tatsuya Shonaka, Daisuke Koga, Yoshiki Hira, Yuji Nishikawa, Hiroyuki Furukawa, Tsuyoshi Watanabe
The effects of warm machine perfusion preservation of liver grafts donated after cardiac death on the intracellular three-dimensional ultrastructure of the organelles in hepatocytes remain unclear. Here we analyzed comparatively the ultrastructure of the endomembrane systems in porcine hepatocytes under warm ischemia and successive hypothermic and midthermic machine perfusion preservation, a type of the warm machine perfusion. Porcine liver grafts which had a warm ischemia time of 60 minutes were perfused for 4 hours with modified University of Wisconsin gluconate solution...
2017: PloS One
https://www.readbyqxmd.com/read/29018070/hypothermic-oxygenated-machine-perfusion-hope-for-orthotopic-liver-transplantation-of-human-liver-allografts-from-extended-criteria-donors-ecd-in-donation-after-brain-death-dbd-a-prospective-multicentre-randomised-controlled-trial-hope-ecd-dbd
#18
Zoltan Czigany, Wenzel Schöning, Tom Florian Ulmer, Jan Bednarsch, Iakovos Amygdalos, Thorsten Cramer, Xavier Rogiers, Irinel Popescu, Florin Botea, Jiří Froněk, Daniela Kroy, Alexander Koch, Frank Tacke, Christian Trautwein, Rene H Tolba, Marc Hein, Ger H Koek, Cornelis H C Dejong, Ulf Peter Neumann, Georg Lurje
INTRODUCTION: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28923649/hypothermic-machine-perfusion-s-protection-on-porcine-kidney-graft-uncovers-greater-akt-erk-phosphorylation
#19
N He, J-H Li, J-J Jia, K-D Xu, Y-F Zhou, L Jiang, H-H Lu, S-Y Yin, H-Y Xie, L Zhou, S-S Zheng
BACKGROUND: To investigate the potential mechanisms of hypothermic machine perfusion (HMP)'s beneficial effects on kidney graft over static cold storage (SCS) in vitro. METHODS: Ten kidneys of 5 Bama miniature male pigs were paired into 2 groups: SCS group and HMP group. Preservation solutions were taken at 0, 1, 3, and 6 hours for the measurement of K(+), Na(+), Cl(-), blood urea nitrogen (BUN), creatinine (Cr), and lactate dehydrogenase (LDH) using the standard laboratory methods...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#20
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
December 2017: Current Opinion in Organ Transplantation
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