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"Machine Perfusion"

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https://www.readbyqxmd.com/read/28403128/an-oxygenated-and-transportable-machine-perfusion-system-fully-rescues-liver-grafts-exposed-to-lethal-ischemic-damage-in-a-pig-model-of-dcd-liver-transplantation
#1
Philippe Compagnon, Eric Levesque, Hassen Hentati, Mara Disabato, Julien Calderaro, Cyrille Feray, Anne Corlu, José Laurent Cohen, Ismail Ben Mosbah, Daniel Azoulay
BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by IV injection of potassium chloride...
April 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28398965/a-novel-approach-in-combined-liver-and-kidney-transplantation-with-long-term-outcomes
#2
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/28394402/dual-hypothermic-oxygenated-machine-perfusion-in-liver-transplants-donated-after-circulatory-death
#3
R van Rijn, N Karimian, A P M Matton, L C Burlage, A C Westerkamp, A P van den Berg, R H J de Kleine, M T de Boer, T Lisman, R J Porte
BACKGROUND: Experimental studies have suggested that end-ischaemic dual hypothermic oxygenated machine perfusion (DHOPE) may restore hepatocellular energy status and reduce reperfusion injury in donation after circulatory death (DCD) liver grafts. The aim of this prospective case-control study was to assess the safety and feasibility of DHOPE in DCD liver transplantation. METHODS: In consecutive DCD liver transplantations, liver grafts were treated with end-ischaemic DHOPE...
April 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28390094/early-experience-with-hypothermic-machine-perfusion-of-living-donor-kidneys
#4
Michael Moser, Nathan Ginther, Yigang Luo, Gavin Beck, Ronn Ginther, Marla Ewen, Rhianna Matsche-Neufeld, Ahmed Shoker, Grzegorz Sawicki
BACKGROUND: 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. METHODS: 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)...
April 8, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28353493/hypothermic-machine-perfusion-of-liver-grafts-can-safely-extend-cold-ischemia-for-up-to-20-hours-in-cases-of-necessity
#5
Riccardo De Carlis, Andrea Lauterio, Fabio Ferla, Stefano Di Sandro, Raffaella Sguinzi, Luciano De Carlis
No abstract text is available yet for this article.
March 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28351756/oxygenated-hypothermic-machine-perfusion-after-static-cold-storage-improves-endothelial-function-of-extended-criteria-donor-livers
#6
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...
March 25, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28350667/acellular-hypothermic-extracorporeal-perfusion-extends-allowable-ischemia-time-in-a-porcine-whole-limb-replantation-model
#7
Maximilian Kueckelhaus, Alexander Dermietzel, Muayyad Alhefzi, Mario A Aycart, Sebastian Fischer, Nicco Krezdorn, Luccie Wo, Omar H Maarouf, Leonardo V Riella, Reza Abdi, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: One of the major challenges in traumatic amputation is the need to keep ischemia time brief (4 to 6 hours) to avoid ischemic damage and enable successful replantation. The current inability to meet this challenge often leads to traumatic limb loss, which has a considerable detrimental impact on the quality of life of patients. METHODS: The authors' team built a portable extracorporeal membrane oxygenator device for the perfusion of amputated extremities with oxygenated acellular solution under controlled parameters...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28333889/normothermic-ex-situ-liver-preservation-the-new-gold-standard
#8
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...
March 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28301388/cold-storage-or-normothermic-perfusion-for-liver-transplantation-probable-application-and-indications
#9
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...
March 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28301386/kidney-perfusion-some-like-it-hot-others-prefer-to-keep-it-cool
#10
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...
March 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28298706/an-assessment-of-fetal-cerebral-and-hepatic-perfusion-in-normal-pregnancy-and-pre-eclampsia-using-three-dimensional-ultrasound
#11
Susan Addley, Amanda Ali, Stephen Ong
BACKGROUND: Pre-eclampsia and placental causes of intrauterine growth restriction (IUGR) are part of the same spectrum of disorders. In IUGR, there is preferential shunting of blood to the fetal brain at the expense of other organs. We wanted to demonstrate that this also occurs in pre-eclampsia using three dimensional (3D) ultrasound. The 3D indices of perfusion are: flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which reflect tissue vascularity and flow intensity...
January 2017: Ulster Medical Journal
https://www.readbyqxmd.com/read/28266940/role-of-temperature-in-reconditioning-and-evaluation-of-cold-preserved-kidney-and-liver-grafts
#12
Thomas Minor, Charlotte von Horn, Andreas Paul
PURPOSE OF REVIEW: Organ shortage in transplantation medicine forces surgical research toward the development of more efficient approaches in organ preservation to enable the application of 'less than optimal' grafts. This review summarizes current techniques aiming to recondition cold-stored organ grafts prior to transplantation to reduce reperfusion-induced tissue injury and improve postimplantation graft function. RECENT FINDINGS: End-ischemic reconditioning has classically been attempted by cold oxygenated perfusion...
March 6, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#13
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28240817/liver-ex-vivo-machine-perfusion-preservation-a-review-of-the-methodology-and-results-of-large-animal-studies-and-clinical-trials
#14
REVIEW
Hazel Marecki, Adel Bozorgzadeh, Robert Porte, Henri Leuvenink, Korkut Uygun, Paulo Martins
Ex-vivo machine perfusion is a promising way to better preserve livers prior to transplantation. Currently, no methodology has verified benefit over simple cold storage. Before becoming clinically feasible, machine perfusion requires validation in models that reliably predict human performance. Such a model has been found in porcine liver, who's physiological, anatomical, and immunological characteristics closely resemble the human liver. Since the 1930s, researchers have explored machine perfusion as preservation, but only recently have clinical trials been performed...
February 27, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28220319/cfd-assessment-of-the-effect-of-convective-mass-transport-on-the-intracellular-clearance-of-intracellular-triglycerides-in-macrosteatotic-hepatocytes
#15
Gabriel Yarmush, Lucas Santos, Joshua Yarmush, Srivathsan Koundinyan, Mubasher Saleem, Nir I Nativ, Martin L Yarmush, Francois Berthiaume, Timothy J Maguire, Chris Guaghan
Donor livers available to transplant for patients with end-stage liver disease are in severe shortage. One possible avenue to expand the donor pool is to recondition livers that would be otherwise discarded due to excessive fat content. Severely steatotic livers (also known as fatty livers) are highly susceptible to ischemia-reperfusion injury and as a result, primary liver non-function post-transplantation. Prior studies in isolated perfused rat livers suggest that "defatting" may be possible in a timeframe of a few hours; thus, it is conceivable that fatty liver grafts could be recovered by machine perfusion to clear stored fat from the organ prior to transplantation...
February 20, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28209945/effects-of-static-cold-storage-and-hypothermic-machine-perfusion-on-oxidative-stress-factors-adhesion-molecules-and-zinc-finger-transcription-factor-proteins-before-and-after-liver-transplantation
#16
De-Fang Zhao, Qin Dong, Tong Zhang
BACKGROUND This study aimed to investigate the effects of static cold storage (SCS) and hypothermic machine perfusion (HMP) on the oxidative stress factors (OSF), adhesion molecules (AM), and zinc finger transcription factor (Snail) before and after liver transplantation. MATERIAL AND METHODS Experimental dogs were randomly divided into donor (group A), SCS (group B), and HMP (group C) (n=30) groups. Livers retrieved from group A were transplanted into group B after SCS, and the livers sampled from group B were transplanted into group C after HMP...
February 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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
#17
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/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#18
María José Pérez-Sáez, Núria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
April 2017: Transplantation
https://www.readbyqxmd.com/read/28035688/reconditioning-by-endischaemic-hypothermic-in-house-machine-perfusion-a-promising-strategy-to-improve-outcome-in-ecd-kidney-transplantation
#19
Anja Gallinat, Vera Amrillaeva, Dieter P Hoyer, Peri Kocabayoglu, Tamas Benko, Jürgen W Treckmann, Marieke van Meel, Undine Samuel, Thomas Minor, Andreas Paul
This clinical study evaluates end-ischaemic hypothermic machine perfusion (eHMP) in ECD kidneys. eHMP was initiated upon arrival of the kidney in our center and continued until transplantation. Between 11/2011 and 8/2014 eHMP was performed in 66 ECD-kidneys for 369 (98-912) minutes after 863 (364-1567) minutes of CS. In 49 out of 66 cases the contralateral kidney from the same donor was preserved by static cold storage (CS) only and accepted by another Eurotransplant center. Fife (10.2%) of these kidneys were ultimately judged as "not transplantable" by the accepting center and discarded...
December 30, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28018757/trends-in-usage-and-outcomes-for-expanded-criteria-donor-kidney-transplantation-in-the-united-states-characterized-by-kidney-donor-profile-index
#20
Aparna Rege, Bill Irish, Anthony Castleberry, Deepak Vikraman, Scott Sanoff, Kadiyala Ravindra, Bradley Collins, Debra Sudan
There has been increasing concern in the kidney transplant community about the declining use of expanded criteria donors (ECD) despite improvement in survival and quality of life. The recent introduction of the Kidney Donor Profile Index (KDPI), which provides a more granular characterization of donor quality, was expected to increase utilization of marginal kidneys and decrease the discard rates. However, trends and practice patterns of ECD kidney utilization on a national level based on donor organ quality as per KDPI are not well known...
November 22, 2016: Curēus
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