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Normothermic perfusion

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https://www.readbyqxmd.com/read/28719038/static-cerebrovascular-pressure-autoregulation-remains-intact-during-deep-hypothermia
#1
Dheeraj Goswami, Katherine McLeod, Samantha Leonard, Kathleen Kibler, Ronald Blaine Easley, Charles D Fraser, Dean Andropoulos, Ken Brady
BACKGROUND: Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. AIM: We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. METHODS: Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass...
July 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28712864/thermal-comfort-zone-of-the-hands-feet-and-head-in-males-and-females
#2
Urša Ciuha, Igor B Mekjavic
INTRODUCTION: The present study compared the thermal comfort zones (TCZ) of the hands, feet and head in eight male and eight female participants, assessed with water-perfused segments (WPS). METHODS: On separate occasions, and separated by a minimum of one day, participants were requested to regulate the temperature of three distal skin regions (hands, feet and head) within their TCZ. On each occasion they donned a specific water-perfused segment (WPS), either gloves, socks or hood for assessing the TCZ of the hands, feet and head, respectively...
July 13, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28693932/muscle-tissue-saturation-compared-with-muscle-tissue-perfusion-during-low-blood-flows-an-experimental-study
#3
Sisse Anette Thomassen, Benedict Kjærgaard, Aage Kristian Olsen Alstrup, Ole Lajord Munk, Jørgen Frøkiær, Anders Larsson, Bodil Steen Rasmussen
OBJECTIVE: To investigate whether changes in muscle tissue perfusion measured with positron emission tomography would be reflected by parallel changes in muscle tissue oxygen saturation (StO2) measured using near-infrared spectroscopy during high and low blood flow levels achieved using cardiopulmonary bypass (CPB) in an animal model. DESIGN: A prospective, randomized study. SETTING: Research laboratory, single institution. PARTICIPANTS: Eight pigs (69-71 kg)...
March 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28682946/cerebral-alterations-following-experimental-multiple-trauma-and-hemorrhagic-shock
#4
Nina Vogt, Christiane Herden, Elke Roeb, Martin Roderfeld, Daphne Eschbach, Thorsten Steinfeldt, Hinnerk Wulf, Steffen Ruchholtz, Eberhard Uhl, Karsten Schöller
Multiple trauma (MT) associated with hemorrhagic shock (HS) might lead to cerebral hypoperfusion and brain damage. We investigated cerebral alterations using a new porcine MT/HS model without traumatic brain injury (TBI) and assessed the neuroprotective properties of mild therapeutic hypothermia. Male pigs underwent standardized MT with HS (45% or 50% loss of blood volume) and resuscitation after 90/120 minutes (T90/T120). In additional groups (TH90/TH120) mild hypothermia (33°C) was induced following resuscitation...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28624105/hypo-and-normothermic-perfusion-of-the-liver-which-way-to-go
#5
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/28623225/high-peripheral-temperatures-in-king-penguins-while-resting-at-sea-thermoregulation-versus-fat-deposition
#6
Agnes Lewden, Manfred R Enstipp, Baptiste Picard, Tessa van Walsum, Yves Handrich
Marine endotherms living in cold water face an energetically challenging situation. Unless properly insulated these animals will lose heat rapidly. The field metabolic rate of king penguins at sea is about twice that on land. However, when at sea, their metabolic rate is higher during extended resting periods at the surface than during foraging, when birds descend to great depth in pursuit of their prey. This is most likely explained by differences in thermal status. During foraging peripheral vasoconstriction leads to a hypothermic shell, which is rewarmed during extended resting bouts at the surface...
June 16, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28591558/validation-of-a-new-proposal-to-avoid-donor-resuscitation-in-controlled-donation-after-circulatory-death-with-normothermic-regional-perfusion
#7
Jose Miguel Perez-Villares, Juan José Rubio, Francisco Del Río, Eduardo Miñambres
AIM: The use of abdominal normothermic regional perfusion (nRP) and premortem interventions in controlled donation after circulatory death (cDCD) may represent a significant advance to increase the number and quality of grafts recovered in cDCD. The main limitation for the widespread acceptance of nRP in cDCD is the concerns of restoring circulation to the brain once death has been declared should the thoracic aorta not be adequately blocked. METHODS: We describe and validate a specific methodology to ensure an appropriate blocking of the thoracic aorta in a multicenter study using this technique...
June 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28574105/development-of-a-prolonged-warm-ex-vivo-perfusion-model-for-kidneys-donated-after-cardiac-death
#8
Daniel Urcuyo, Matthew F Blum, Qiang Liu, Ahmed Nassar, Laura D Buccini, Teresa Diago Uso, Emilio D Poggio, William M Baldwin Iii, David A Goldfarb, Cristiano Quintini
PURPOSE: Ex vivo perfusion of marginal kidney grafts offers the chance to expand the donor pool, but there is no current clinical standard for the prolonged warm perfusion of renal grafts. This exploratory pilot study seeks to identify a stable ex vivo kidney perfusion model that can support low intravascular resistance and preserve histologic architecture in a porcine donation after cardiac death (DCD) model. METHODS: 15 kidneys were preserved in 1 of 3 settings: normothermic whole blood (NT-WB), normothermic Steen Solution™ (XVIVO Perfusion) with whole blood (NT-Steen/WB), or subnormothermic Steen Solution™ at 21°C (SNT-Steen)...
June 9, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28557562/mesenchymal-stromal-cells-as-anti-inflammatory-and-regenerative-mediators-for-donor-kidneys-during-normothermic-machine-perfusion
#9
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...
June 26, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#10
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28520579/the-use-of-an-acellular-oxygen-carrier-in-a-human-liver-model-of-normothermic-machine-perfusion
#11
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/28520564/normothermic-cardiopulmonary-bypass-in-patient-with-waldenstr%C3%A3-m-s-macroglobulinemia-and-cryoglobulinemia-a-case-report
#12
Shiho Satomi, Asuka Kasai, Eisuke Hamaguchi, Yasuo M Tsutsumi, Katsuya Tanaka
Waldenström's macroglobulinemia (WM) manifests as hyperviscosity syndrome. Cryoglobulinemia, which may increase blood viscosity or induce thrombosis in association with decreased body temperature, can occur in combination with WM. We describe the management of an 82-year-old woman with WM, hyperviscosity syndrome, and cryoglobulinemia who required open aortic valve replacement. Decreased body temperature in this patient was prevented during cardiopulmonary bypass by using a forced air warming system and normothermic cardioplegia with continuous warm blood cardioplegia perfusion...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28493634/an-experimental-study-of-the-recovery-of-injured-porcine-lungs-with-prolonged-normothermic-cellular-ex-vivo-lung-perfusion-following-donation-after-circulatory-death
#13
John R Spratt, Lars M Mattison, Paul A Iaizzo, Roland Z Brown, Haylie Helms, Tinen L Iles, Brian Howard, Angela Panoskaltsis-Mortari, Gabriel Loor
INTRODUCTION: Donation after circulatory death (DCD) is an underused source of donor lungs. Normothermic cellular ex vivo lung perfusion (EVLP) is effective in preserving standard donor lungs but may also be useful in the preservation and assessment of DCD lungs. METHODS: Using a model of DCD and prolonged EVLP, the effects of donor warm ischemia and postmortem ventilation on graft recovery were evaluated. Adult male swine underwent general anesthesia and heparinization...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28483273/ex-vivo-machine-perfusion-for-renal-graft-preservation
#14
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
#15
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
#16
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/28437389/normothermic-perfusion-in-the-assessment-and-preservation-of-declined-livers-before-transplantation-hyperoxia-and-vasoplegia-important-lessons-from-the-first-12-cases
#17
Christopher J E Watson, Vasilis Kosmoliaptsis, Lucy V Randle, Alexander E Gimson, Rebecca Brais, John R Klinck, Mazin Hamed, Anastasia Tsyben, Andrew J Butler
BACKGROUND: A program of normothermic ex situ liver perfusion (NESLiP) was developed to facilitate better assessment and use of marginal livers, while minimizing cold ischemia. METHODS: Declined marginal livers and those offered for research were evaluated. Normothermic ex situ liver perfusion was performed using an erythrocyte-based perfusate. Viability was assessed with reference to biochemical changes in the perfusate. RESULTS: Twelve livers (9 donation after circulatory death [DCD] and 3 from brain-dead donors), median Donor Risk Index 2...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28434548/ex%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#18
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Morgan Salmon, Dustin Money, Sarah Schubert, Mark H Stoler, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the number one cause of lung injury in adults. Ex vivo lung perfusion (EVLP) is gaining clinical acceptance for donor lung evaluation and rehabilitation and may expand the use of marginal organs for transplantation. We hypothesized that 4 hours of normothermic EVLP would improve compliance and oxygenation in a porcine model of sepsis-induced lung injury. METHODS: We used intravenous lipopolysaccharide (LPS) to induce a systemic inflammatory response in a porcine model of lung injury...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28426449/temperature-and-oxygenation-during-organ-preservation-friends-or-foes
#19
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/28409155/preservation-of-myocardial-perfusion-and-function-by-keeping-hypertrophied-heart-empty-and-beating-for-valve-surgery-an-in-vivo-mr-study-of-pig-hearts
#20
Jian Wang, Bo Xiang, Jixian Deng, Hung-Yu Lin, Darren H Freed, Rakesh C Arora, Ganghong Tian
Objectives. Normothermic hyperkalemic cardioplegia arrest (NHCA) may not effectively preserve hypertrophied myocardium during open-heart surgery. Normothermic normokalemic beating perfusion (NNBP), keeping hearts empty-beating, was utilized as an alternative to evaluate its cardioprotective role. Materials and Methods. Twelve hypertrophied pig hearts at 58.6 ± 7.2 days after ascending aorta banding underwent NNBP and NHCA, respectively. Near infrared myocardial perfusion imaging with indocyanine green (ICG) was conducted to assess myocardial perfusion...
2017: BioMed Research International
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