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"Machine Perfusion"

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https://www.readbyqxmd.com/read/29239091/extra-corporeal-normothermic-machine-perfusion-of-the-porcine-kidney-working-towards-future-utilization-in-australasia
#1
Ahmer M Hameed, Ray Miraziz, David B Lu, Neil Warwick, Ali El-Ayoubi, Heather Burns, Yi Vee Chew, Ross Matthews, Greg O'Grady, Lawrence Yuen, Natasha Rogers, Henry C Pleass, Wayne J Hawthorne
BACKGROUND: The ongoing supply-demand gap with respect to donor kidneys for transplantation necessitates the increased use of higher kidney donor profile index and/or donation after circulatory death (DCD) kidneys. Machine perfusion (MP) preservation has become increasingly popular as a means to preserve such organs. Human data regarding normothermic kidney MP (NMP) is in its infancy, and such a system has not been established in the Australasian clinical setting. METHODS: Modified cardio-pulmonary bypass technology was utilized to develop a viable NMP kidney perfusion system using a porcine DCD model...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#2
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
December 6, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29191459/impact-of-real-time-metabolomics-in-liver-transplantation-graft-evaluation-and-donor-recipient-matching
#3
Francois Faitot, Camille Besch, Stephanie Battini, Elisa Ruhland, Mihaela Onea, Pietro Addeo, Marie-Lorraine Woehl-Jaeglé, Bernard Ellero, Philippe Bachellier, Izzie-Jacques Namer
BACKGROUND AND AIMS: The purpose of this study was to evaluate the potential value of high-resolution magic-angle-spinning nuclear magnetic resonance (HR-MAS-NMR) metabolomic analysis of back-table biopsies for the prediction of early allograft dysfunction and donor-recipient matching. Indeed there is an emerging need to assess the metabolic state of liver allograft especially in the novel setting of machine perfusion preservation and DCD grafts. HR-MAS-NMR could be a useful tool in this setting as it can extemporaneously provide untargeted metabolic profile...
November 27, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29189484/comparison-of-bq123-epoprostenol-and-verapamil-as-vasodilators-during-normothermic-ex-vivo-liver-machine-perfusion
#4
Juan Echeverri, Nicolas Goldaracena, Johan Moritz Kaths, Ivan Linares, Roizar Roizales, Dagmar Kollmann, Matyas Hamar, Peter Urbanellis, Sujani Ganesh, Oyedele A Adeyi, Mahmood Tazari, Markus Selzner, Nazia Selzner
BACKGROUND: The optimal vasodilator to avoid hepatic artery (HA) vasospasm during normothermic ex vivo liver perfusion (NEVLP) is yet to be determined. We compared safety and efficacy of BQ123 (endothelin1 antagonist), Epoprostenol (prostacyclin analogue), and Verapamil (calcium channel antagonist). METHODS: Livers from porcine heart beating donors were perfused for 3 hours and transplanted into recipient pigs. Four groups were compared: Group 1: livers perfused with a dose of 1...
November 20, 2017: Transplantation
https://www.readbyqxmd.com/read/29187644/nanoparticle-targeting-to-the-endothelium-during-normothermic-machine-perfusion-of-human-kidneys
#5
Gregory T Tietjen, Sarah A Hosgood, Jenna DiRito, Jiajia Cui, Deeksha Deep, Eric Song, Jan R Kraehling, Alexandra S Piotrowski-Daspit, Nancy C Kirkiles-Smith, Rafia Al-Lamki, Sathia Thiru, J Andrew Bradley, Kourosh Saeb-Parsy, John R Bradley, Michael L Nicholson, W Mark Saltzman, Jordan S Pober
Ex vivo normothermic machine perfusion (NMP) is a new clinical strategy to assess and resuscitate organs likely to be declined for transplantation, thereby increasing the number of viable organs available. Short periods of NMP provide a window of opportunity to deliver therapeutics directly to the organ and, in particular, to the vascular endothelial cells (ECs) that constitute the first point of contact with the recipient's immune system. ECs are the primary targets of both ischemia-reperfusion injury and damage from preformed antidonor antibodies, and reduction of perioperative EC injury could have long-term benefits by reducing the intensity of the host's alloimmune response...
November 29, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29183928/viability-testing-and-transplantation-of-marginal-livers-vittal-using-normothermic-machine-perfusion-study-protocol-for-an-open-label-non-randomised-prospective-single-arm-trial
#6
Richard W Laing, Hynek Mergental, Christina Yap, Amanda Kirkham, Manpreet Whilku, Darren Barton, Stuart Curbishley, Yuri L Boteon, Desley A Neil, Stefan G Hübscher, M Thamara P R Perera, Paolo Muiesan, John Isaac, Keith J Roberts, Hentie Cilliers, Simon C Afford, Darius F Mirza
INTRODUCTION: The use of marginal or extended criteria donor livers is increasing. These organs carry a greater risk of initial dysfunction and early failure, as well as inferior long-term outcomes. As such, many are rejected due to a perceived risk of use and use varies widely between centres. Ex situ normothermic machine perfusion of the liver (NMP-L) may enable the safe transplantation of organs that meet defined objective criteria denoting their high-risk status and are currently being declined for use by all the UK transplant centres...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29173394/outcome-after-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#7
Simon Messer, Aravinda Page, Richard Axell, Marius Berman, Jules Hernández-Sánchez, Simon Colah, Barbora Parizkova, Kamen Valchanov, John Dunning, Evgeny Pavlushkov, Sendhil K Balasubramanian, Jayan Parameshwar, Yasir Abu Omar, Martin Goddard, Stephen Pettit, Clive Lewis, Anna Kydd, David Jenkins, Christopher J Watson, Catherine Sudarshan, Pedro Catarino, Marie Findlay, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: The requirement for heart transplantation is increasing, vastly outgrowing the supply of hearts available from donation after brain death (DBD) donors. Transplanting hearts after donation after circulatory-determined death (DCD) may be a viable additive alternative to DBD donors. This study compared outcomes from the largest single-center experience of DCD heart transplantation against matched DBD heart transplants. METHODS: DCD hearts were retrieved using normothermic regional perfusion (NRP) or direct procurement and perfusion (DPP)...
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29155020/the-uk-dcd-risk-score-a-new-proposal-to-define-futility-in-donation-after-circulatory-death-liver-transplantation
#8
Andrea Schlegel, Marit Kalisvaart, Irene Scalera, Richard W Laing, Hynek Mergental, Darius F Mirza, Thamara Perera, John Isaac, Philipp Dutkowski, Paolo Muiesan
OBJECTIVES: To design a new score on risk assessment in liver transplantation donated after circulatory death (DCD) based on donor and recipient parameters. BACKGROUND: Primary-non-function (PNF) and ischemic cholangiopathy (IC) are the most feared complications following DCD liver transplantation. METHODS: Using the United Kingdom (UK) national DCD database, a risk analysis was performed in adult recipients of DCD liver grafts in UK between 2000 and 2015 (n=1153)...
November 15, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29142469/hypothermic-machine-perfusion-with-metformin-university-of-wisconsin-solution-for-ex-vivo-preservation-of-standard-and-marginal-liver-grafts-in-a-rat-model
#9
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/29137180/metabolomic-modularity-analysis-mma-to-quantify-human-liver-perfusion-dynamics
#10
Gautham Vivek Sridharan, Bote Bruinsma, Shyam Sundhar Bale, Anandh Swaminathan, Nima Saeidi, Martin L Yarmush, Korkut Uygun
Large-scale -omics data are now ubiquitously utilized to capture and interpret global responses to perturbations in biological systems, such as the impact of disease states on cells, tissues, and whole organs. Metabolomics data, in particular, are difficult to interpret for providing physiological insight because predefined biochemical pathways used for analysis are inherently biased and fail to capture more complex network interactions that span multiple canonical pathways. In this study, we introduce a nov-el approach coined Metabolomic Modularity Analysis (MMA) as a graph-based algorithm to systematically identify metabolic modules of reactions enriched with metabolites flagged to be statistically significant...
November 13, 2017: Metabolites
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
#11
Kamlesh Patel, Jay Nath, James Hodson, Nick Inston, Andrew Ready
Evidence is currently lacking regarding the outcomes of kidneys undergoing Hypothermic Machine Perfusion (HMP) in the UK. 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 to those 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 SCS (34...
November 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#12
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29125712/lipid-metabolism-and-functional-assessment-of-discarded-human-livers-with-steatosis-undergoing-24-hours-normothermic-machine-perfusion
#13
Qiang Liu, Ahmed Nassar, Laura Buccini, Giuseppe Iuppa, Basem Soliman, Daniele Pezzati, Ahmed Hassan, Matthew Blum, William Baldwin, Ana Bennett, Kenneth Chavin, Toshihiro Okamoto, Teresa Diago Uso, John Fung, Kareem Abu-Elmagd, Charles Miller, Cristiano Quintini
Normothermic machine perfusion (NMP) is an emerging technology to preserve liver allografts more effectively than cold storage (CS). However, little is known about the effect of NMP on steatosis, and the markers indicative of hepatic quality during NMP. To address these points we perfused 10 discarded human livers with oxygenated NMP for 24 hours after 4-6 hours of CS. All livers had variable degree of steatosisat at baseline. The perfusate consisted of packed red blood cells and fresh frozen plasma. Perfusate analysis showed an increase in triglyceride levels from the 1st hour (median 127 mg/dL; interquartile range 95-149) to 24th hour of perfusion (203;171-304) (p=0...
November 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29109929/opportunities-for-therapeutic-intervention-during-machine-perfusion
#14
Negin Karimian, Heidi Yeh
Purpose of review: There is a vast discrepancy between the number of patients waiting for organ transplantation and the available donor organs. Ex vivo machine perfusion (MP) has emerged in an effort to expand the donor pool, by improving organ preservation, providing diagnostic information, and more recently, acting as a platform for organ improvement. This article reviews the current status of MP with a focus on its role in organ preconditioning and therapeutic interventions prior to transplantation...
June 2017: Current Transplantation Reports
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/29054354/strategies-to-reduce-ischemia-reperfusion-injury-in-vascularized-composite-allotransplantation-of-the-limb
#16
REVIEW
Kavit R Amin, Jason K F Wong, James E Fildes
An important and often underinvestigated contributor to solid organ transplant rejection is ischemia reperfusion injury. This pathophysiological response releases damaging reactive oxygen species and cell stress signals that initiate inflammation, which has a critical role in priming the immune system for allorecognition. In time, this renders graft dysfunction and how this response is mediated in composite tissues remains unknown. Current protocols are drawn from solid organ transplantation with little scientific basis as to how this informs current hand transplantation practices...
October 18, 2017: Journal of Hand Surgery
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
#17
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/29024427/combined-liver-kidney-perfusion-enhances-protective-effects-of-normothermic-perfusion-on-livers-grafts-from-donation-after-cardiac-death
#18
Xiaoshun He, Fei Ji, Zhiheng Zhang, Yunhua Tang, Lu Yang, Shanzhou Huang, Wenwen Li, Qiao Su, Wei Xiong, Zebin Zhu, Linhe Wang, Lei Lv, Jiyou Yao, Linan Zhang, Longjuan Zhang, Zhiyong Guo
It has been showed that combined liver-kidney normothermic machine perfusion (NMP) is able to better maintain the circuit's biochemical milieu. Nevertheless, whether the combined perfusion is superior to liver perfusion alone in protecting livers from donation after cardiac death (DCD) is unclear. We aimed to test the hypothesis and explored the mechanisms. Livers from 15 DCD pig donors were subjected to either static cold storage group (Group A), liver alone NMP group (Group B), or combined liver-kidney NMP group (Group C)...
October 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29023512/the-ultrastructural-characteristics-of-porcine-hepatocytes-donated-after-cardiac-death-and-preserved-with-warm-machine-perfusion-preservation
#19
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
#20
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
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