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Normothermic Ex vivo perfusion

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https://www.readbyqxmd.com/read/29730077/ex-vivo-normothermic-porcine-pancreas-a-physiological-model-for-preservation-and-transplant-study
#1
Rohan Kumar, Wen Yuan Chung, Franscois Runau, John David Isherwood, Kean Guan Kuan, Kevin West, Giuseppe Garcea, Ashley Robert Dennison
INTRODUCTION: An ex vivo normothermic porcine pancreas perfusion (ENPPP) model was established to investigate effects of machine perfusion pressures on graft preservation. METHODOLOGY: Nine porcine pancreata were perfused with autologous blood at 50 mmHg (control) pressure. Graft viability was compared against four ex-vivo porcine pancreata perfused at 20 mmHg ('low') pressure. Arterio-venous oxygen gas differentials, biochemistry, and graft insulin responses to glucose stimulation were compared...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29697462/ex-vivo-machine-perfusion-for-kidney-preservation
#2
Matyas Hamar, Markus Selzner
PURPOSE OF REVIEW: Machine perfusion is a novel strategy to decrease preservation injury, improve graft assessment, and increase organ acceptance for transplantation. This review summarizes the current advances in ex-vivo machine-based kidney preservation technologies over the last year. RECENT FINDINGS: Ex-vivo perfusion technologies, such as hypothermic and normothermic machine perfusion and controlled oxygenated rewarming, have gained high interest in the field of organ preservation...
April 24, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29683999/normothermic-ex-vivo-kidney-perfusion-reduces-warm-ischemic-injury-of-porcine-kidney-grafts-retrieved-after-circulatory-death-dcd
#3
Matyas Hamar, Peter Urbanellis, Moritz Johann Kaths, Dagmar Kollmann, Ivan Linares, Sujani Ganesh, Aryn Wiebe, Jun Yu Cen, Paul M Yip, Rohan John, Ana Konvalinka, Istvan Mucsi, Anand Ghanekar, Darius Bagli, David R Grant, Lisa A Robinson, Markus Selzner
BACKGROUND: Cold storage is poorly tolerated by kidney grafts retrieved after Donation after Circulatory Death (DCD). It has been determined that normothermic ex vivo kidney perfusion (NEVKP) preservation decreases injury by minimizing cold ischemic storage. The impact of NEVKP on warm ischemic injury is unknown. METHODS: We compared pig kidneys retrieved after 30minutes warm ischemia and immediate transplantation (no-preservation) with grafts that were exposed to 30min of warm ischemia plus 8hr NEVKP or plus 8hr SCS...
April 21, 2018: Transplantation
https://www.readbyqxmd.com/read/29677080/corm-401-reduces-ischemia-reperfusion-injury-in-an-ex-vivo-renal-porcine-model-of-the-donation-after-cardiac-death
#4
Rabindra N Bhattacharjee, Mahms Richard-Mohamed, Qizhi Sun, Aaron Haig, Ghaleb Aboalsamh, Peter Barrett, Richard Mayer, Ibrahim Alhasan, Karen Pineda-Solis, Larry Jiang, Hajed Alharbi, Manujendra Saha, Eric Patterson, Alp Sener, Gediminas Cepinskas, Anthony M Jevnikar, Patrick P W Luke
BACKGROUND: Carbon monoxide (CO) inhalation protects organ by reducing inflammation and cell death during transplantation processes in animal model. However, using CO in clinical transplantation is difficult due to its delivery in a controlled manner. A manganese-containing CORM-401 has recently been synthesized which can efficiently deliver 3 molar equivalents of CO. We report the ability of this anti-inflammatory CORM-401 to reduce ischemia reperfusion injury associated with prolonged cold storage of renal allografts obtained from donation after cardiac death in a porcine model of transplantation...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29674604/does-ischemia-free-liver-procurement-under-normothermic-perfusion-benefit-the-outcome-of-liver-transplantation
#5
Qiang Zhao, Shanzhou Huang, Dongping Wang, Zhiheng Zhang, Linwei Wu, Lu Yang, Yi Ma, Fei Ji, Yunhua Tang, Linhe Wang, Zebin Zhu, Yanling Zhu, Wei Xiong, Maogen Chen, Ming Han, Jian Zhou, Anbin Hu, Guodong Wang, Xingyuan Jiao, Xiaofeng Zhu, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
BACKGROUND In contrast to conventional static cold preservation, normothermic machine perfusion (NMP) provides a beneficial alternative preservation of donor livers. However, the liver still suffered cold ischemic injury before attaching to the perfusion device. MATERIAL AND METHODS To prevent cold ischemic injury during procurement, we describe a novel procedure called ischemia-free liver procurement (IFLP) under NMP. Two liver grafts were procured from brain death donor under NMP and underwent 2-hour ex vivo NMP followed by 3 and 6 hours of static cold preservation...
April 20, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29539938/re-eight-hour-continuous-normothermic-ex-vivo-kidney-perfusion-is-a-safe-preservation-technique-for-kidney-transplantation-a-new-opportunity-for-the-storage-assessment-and-repair-of-kidney-grafts
#6
https://www.readbyqxmd.com/read/29446226/towards-donor-lung-recovery-gene-expression-changes-during-ex-vivo-lung-perfusion-of-human-lungs
#7
Jonathan C Yeung, Ricardo Zamel, William Klement, Xiao-Hui Bai, Tiago N Machuca, Thomas K Waddell, Mingyao Liu, Marcelo Cypel, Shaf Keshavjee
We and others have demonstrated that acellular normothermic ex vivo lung perfusion of high-risk donor lungs can result in posttransplant outcomes equivalent to that of contemporaneous lung transplantation using standard donor lungs. However, the mechanism of this effect remains unclear. Given the restoration of cellular metabolic activity during normothermic perfusion, one possibility is that of lung healing via natural innate recovery mechanisms. We explored this by examining the gene expression changes occurring in human lungs during ex vivo lung perfusion...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29424767/extracellular-vesicles-from-human-liver-stem-cells-reduce-injury-in-an-ex-vivo-normothermic-hypoxic-rat-liver-perfusion-model
#8
Federica Rigo, Nicola De Stefano, Victor Navarro-Tableros, Ezio David, Giorgia Rizza, Giorgia Catalano, Nicholas Gilbo, Francesca Maione, Federica Gonella, Dorotea Roggio, Silvia Martini, Damiano Patrono, Mauro Salizzoni, Giovanni Camussi, Renato Romagnoli
BACKGROUND: The gold standard for organ preservation before transplantation is static cold storage, which is unable to fully protect suboptimal livers from ischemia/reperfusion injury. An emerging alternative is normothermic machine perfusion (NMP), which permits organ reconditioning. Here, we aimed to explore the feasibility of a pharmacological intervention on isolated rat livers by using a combination of NMP and human liver stem cells-derived extracellular vesicles (HLSC-EV). METHODS: We established an ex vivo murine model of NMP capable to maintain liver function despite an ongoing hypoxic injury induced by hemodilution...
May 2018: Transplantation
https://www.readbyqxmd.com/read/29382512/steroids-limit-myocardial-edema-during-ex-vivo-perfusion-of-hearts-donated-after-circulatory-death
#9
Jaskiran K Sandha, Christopher W White, Alison Müller, Emma Avery, James Thliveris, Ian M C Dixon, Rakesh C Arora, Ganghong Tian, Larry V Hryshko, Jayan Nagendran, Darren H Freed
BACKGROUND: Normothermic ex vivo heart perfusion (EVHP) has been shown to improve the preservation of hearts donated after circulatory arrest and to facilitate clinical successful transplantation. Steroids are added to the perfusate solution in current clinical EVHP protocols; however, the impact of this approach on donor heart preservation has not been previously investigated. We sought to determine the impact of steroids on the inflammatory response and development of myocardial edema during EVHP...
January 31, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29300233/microbial-contamination-during-kidney-ex-vivo-normothermic-perfusion
#10
Benedict L Phillips, Pankaj Chandak, Raphael Uwechue, Claire van Nispen Tot Pannerden, Caroline Hemsley, Chris J Callaghan
No abstract text is available yet for this article.
April 2018: Transplantation
https://www.readbyqxmd.com/read/29240608/metabolic-profile-of-ex-vivo-lung-perfusate-yields-biomarkers-for-lung-transplant-outcomes
#11
Michael K Hsin, Ricardo Zamel, Marcelo Cypel, David Wishart, Beomsoo Han, Shaf Keshavjee, Mingyao Liu
OBJECTIVE: To identify potential biomarkers during ex vivo lung perfusion (EVLP) using metabolomics approach. SUMMARY BACKGROUND DATA: EVLP increases the number of usable donor lungs for lung transplantation (LTx) by physiologic assessment of explanted marginal lungs. The underlying paradigm of EVLP is the normothermic perfusion of cadaveric lungs previously flushed and stored in hypothermic preservation fluid, which allows the resumption of active cellular metabolism and respiratory function...
January 2018: Annals 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
#12
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...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29189484/comparison-of-bq123-epoprostenol-and-verapamil-as-vasodilators-during-normothermic-ex-vivo-liver-machine-perfusion
#13
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
#14
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/29153638/%C3%AE-1-anti-trypsin-improves-function-of-porcine-donor-lungs-during-ex-vivo-lung-perfusion
#15
Huiqing Lin, Manyin Chen, Feng Tian, Jussi Tikkanen, Lei Ding, Hei Yu Andrew Cheung, Daisuke Nakajima, Zhe Wang, Andrea Mariscal, David Hwang, Marcelo Cypel, Shaf Keshavjee, Mingyao Liu
BACKGROUND: Ex-vivo lung perfusion (EVLP), a technique for donor lung assessment, also represents a platform for donor lung repair and immunomodulation. α1 -Anti-trypsin (A1AT), a medication used to treat emphysema in A1AT-deficient patients, has anti-inflammatory properties and has been shown to attenuate ischemia-reperfusion injury in rat and pig lung transplants. The objective of this study was to determine whether administration of A1AT during EVLP can improve donor lung quality after prolonged hypothermic preservation...
October 2, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29103845/negative-pressure-ventilation-decreases-inflammation-and-lung-edema-during-normothermic-ex-vivo-lung-perfusion
#16
Nader S Aboelnazar, Sayed Himmat, Sanaz Hatami, Christopher W White, Mohamad S Burhani, Peter Dromparis, Nobutoshi Matsumura, Ganghong Tian, Jason R B Dyck, Michael Mengel, Darren H Freed, Jayan Nagendran
BACKGROUND: Normothermic ex-vivo lung perfusion (EVLP) using positive pressure ventilation (PPV) and both acellular and red blood cell (RBC)-based perfusate solutions have increased the rate of donor organ utilization. We sought to determine whether a negative pressure ventilation (NPV) strategy would improve donor lung assessment during EVLP. METHODS: Thirty-two pig lungs were perfused ex vivo for 12 hours in a normothermic state, and were allocated equally to 4 groups according to the mode of ventilation (positive pressure ventilation [PPV] vs NPV) and perfusate composition (acellular vs RBC)...
April 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29070045/haemoadsorption-reduces-the-inflammatory-response-and-improves-blood-flow-during-ex-vivo-renal-perfusion-in-an-experimental-model
#17
Sarah A Hosgood, Tom Moore, Theresa Kleverlaan, Tom Adams, Michael L Nicholson
BACKGROUND: Ex-vivo normothermic perfusion strategies are a promising new instrument in organ transplantation. The perfusion conditions are designed to be protective however the artificial environment can induce a local inflammatory response. The aim of this study was to determine the effect of incorporating a Cytosorb adsorber into an isolated kidney perfusion system. METHODS: Porcine kidneys were subjected to 22 h of cold ischaemia then reperfused for 6 h on an ex vivo reperfusion circuit...
October 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29024427/combined-liver-kidney-perfusion-enhances-protective-effects-of-normothermic-perfusion-on-liver-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 shown 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 circulatory 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 A), liver-alone NMP (group B), or combined liver-kidney NMP (group C)...
January 2018: Liver Transplantation
https://www.readbyqxmd.com/read/28994259/long-distance-heart-transplantation-a-tale-of-two-cities
#19
Pankaj Jain, Roslyn A Prichard, Mark B Connellan, Kumud K Dhital, Peter S Macdonald
In this 'paired' case report, we describe two heart transplants performed 3 days apart at our centre. Both cases involved very prolonged transportation time of the donor heart. In one case, the donor heart was transported in an ice chest, while in the other case the organ was transported using a normothermic ex vivo perfusion (NEVP) system. The additional retrieval costs incurred by the use NEVP were more than offset by the reduction in subsequent inpatient costs.
October 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28985850/the-administration-of-argon-during-ex-vivo-normothermic-perfusion-in-an-experimental-model-of-kidney-ischemia-reperfusion-injury
#20
Stephanie F Smith, Thomas Adams, Sarah A Hosgood, Michael L Nicholson
BACKGROUND: Argon has shown potential as an organoprotective agent in numerous models of ischemia-reperfusion injury (IRI). The aim of this study was to evaluate the effects of argon gas during ex vivo normothermic perfusion (EVNP) in an experimental porcine model of kidney IRI. MATERIALS AND METHODS: After a warm ischemia time of 15 min and 17 h of static cold storage, porcine kidneys underwent 1 h of EVNP using leukocyte-depleted blood. During EVNP, kidneys were perfused with a gas composition either of 70% argon (n = 6), 70% nitrogen control (n = 6), or standard 95% oxygen (n = 6) balanced with 5% carbon dioxide...
October 2017: Journal of Surgical Research
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