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Normothermic perfusion

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https://www.readbyqxmd.com/read/29153638/%C3%AE-1-anti-trypsin-improves-function-of-porcine-donor-lungs-during-ex-vivo-lung-perfusion
#1
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/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#2
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
#3
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/29120882/donation-after-circulatory-death-and-its-expansion-in-spain
#4
Eduardo Miñambres, Juan J Rubio, Elisabeth Coll, Beatriz Domínguez-Gil
PURPOSE OF REVIEW: Donation after circulatory death (DCD) is still performed in a limited number of countries. This article summarizes the development of DCD in Spain and presents recent Spanish contributions to gain knowledge on the potential benefits and the practical use of normothermic regional perfusion (nRP). RECENT FINDINGS: DCD now contributes to 24% of deceased donors in Spain. The development of DCD has been based on an assessment of practices in the treatment of cardiac arrest and end-of-life care to accommodate the option of DCD; the creation of an adequate regulatory framework; and institutional support, professional training and public education...
November 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29103845/negative-pressure-ventilation-decreases-inflammation-and-lung-edema-during-normothermic-ex-vivo-lung-perfusion
#5
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)...
September 14, 2017: 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
#6
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/29069350/a-dose-response-study-of-glutamate-supplementation-in-isolated-perfused-rat-hearts-undergoing-ischaemia-and-cold-cardioplegia
#7
Hans-Henrik Kimose, Flemming Randsbæk, Thomas Decker Christensen, Guro Valen, Hans Erik Bøtker, Jarle Vaage
OBJECTIVES: Several studies have reported superior post-cardioplegic recovery after glutamate supplementation. The optimum dose of glutamate supplementation is unknown. The purpose of this study was to find the optimal protective concentration of glutamate supplementation in a model of ischaemia/cardioplegia and reperfusion. METHODS: Isolated rat hearts (n = 77) were perfused with the Krebs-Henseleit buffer. After stabilization, the hearts were subjected to 25 min of normothermic ischaemia followed by a single 3-min infusion of cold (4-6 °C) St...
October 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29051228/thermal-strategies-of-king-penguins-during-prolonged-fasting-in-water
#8
Agnès Lewden, Manfred R Enstipp, Batshéva Bonnet, Caroline Bost, Jean-Yves Georges, Yves Handrich
Most animals experience periods of unfavourable conditions, challenging their daily energy balance. During breeding, king penguins fast voluntarily for up to 1.5 months in the colony, after which they replenish their energy stores at sea. However, at sea, birds might encounter periods of low foraging profitability, forcing them to draw from previously stored energy (e.g. subcutaneous fat). Accessing peripheral fat stores requires perfusion, increasing heat loss and thermoregulatory costs. Hence, how these birds balance the conflicting demands of nutritional needs and thermoregulation is unclear...
October 19, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29045248/the-evolution-of-donation-after-circulatory-death-donor-kidney-repair-in-the-united-kingdom
#9
Sarah A Hosgood, Michael L Nicholson
PURPOSE OF REVIEW: The increasing reliance on marginal donors has driven research to investigate ways to repair and improve the quality of kidneys for transplantation. Normothermic perfusion technologies provide an opportunity for improved preservation, organ assessment and resuscitation/repair of damaged kidneys. This review describes the evolution of normothermic perfusion in kidney transplantation in the United Kingdom. RECENT FINDINGS: One hour of normothermic perfusion can be used to restore function and improve early graft function of extended criteria donor kidneys...
October 17, 2017: Current Opinion in Organ 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
#10
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/29033043/in%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#11
J Hunter Mehaffey, Eric J Charles, Sarah Schubert, Morgan Salmon, Ashish K Sharma, Dustin Money, Mark H Stoler, Victor E Laubach, Curtis G Tribble, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the leading cause of lung injury in adults and can lead to acute respiratory distress syndrome (ARDS). Using a novel technique of isolated in vivo lung perfusion (IVLP), we hypothesized that normothermic IVLP will improve oxygenation and compliance in a porcine model of sepsis-induced lung injury. METHODS: Mature adult swine (n = 8) were administered lipopolysaccharide (LPS; 50 μg/kg over 2 hours) via the external jugular vein, followed by sternotomy and central extracorporeal membrane oxygenation (ECMO) cannulation (right atrium to ascending aorta)...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29024427/combined-liver-kidney-perfusion-enhances-protective-effects-of-normothermic-perfusion-on-livers-grafts-from-donation-after-cardiac-death
#12
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/28994259/long-distance-heart-transplantation-a-tale-of-two-cities
#13
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/28990205/developing-a-protocol-for-normothermic-ex-situ-limb-perfusion
#14
Eliana F R Duraes, Maria Madajka, Russell Frautschi, Basem Soliman, Cagri Cakmakoglu, Addison Barnett, Kashyap Tadisina, Qiang Liu, Patrick Grady, Cristiano Quintini, Toshihiro Okamoto, Francis Papay, Antonio Rampazzo, Bahar Bassiri Gharb
BACKGROUND: Ischemia time represents a significant limitation for successful extremity transplantation because of the rapid deterioration of ischemic muscle. Normothermic ex-situ preservation is an emergent method to prolong the organ viability following procurement, by replicating the physiologic conditions. The aim of this study was to develop an ex-situ normothermic limb perfusion system to preserve the viability and function of porcine limbs for 12 hours following procurement. METHODS: A total of 18 swine limbs were perfused...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28985850/the-administration-of-argon-during-ex-vivo-normothermic-perfusion-in-an-experimental-model-of-kidney-ischemia-reperfusion-injury
#15
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
https://www.readbyqxmd.com/read/28958063/efficacy-of-esmolol-cardioplegia-during-hypothermic-ischaemia
#16
Dai Nishina, David J Chambers
OBJECTIVES: Cardioplegic arrest using a polarizing solution has been shown to have beneficial advantages for cardioprotection compared with depolarizing (potassium-based) arrest; most studies, however, have looked at normothermic ischaemia with short infusion intervals (every 10-15 min). This study examines the protective efficacy of an esmolol-based cardioplegia during hypothermic arrest, together with a prolonged infusion interval (30 min) for increased clinical feasibility. METHODS: Isolated Langendorff-perfused hearts were subjected to arrest with St Thomas' Hospital cardioplegia (STH2), or esmolol cardioplegia (single- or multidose infusion at 32°C) for 60-min, 90-min or 120-min global ischaemia at 32°C, and recovery of function (left ventricular developed pressure) measured...
September 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28951276/early-transient-mild-hypothermia-attenuates-neurological-deficits-and-brain-damage-after-experimental-subarachnoid-hemorrhage-in-rats
#17
Nadine Lilla, Christoph Rinne, Judith Weiland, Thomas Linsenmann, Ralf-Ingo Ernestus, Thomas Westermaier
OBJECTIVE: Metabolic exhaustion in ischemic tissue is the basis for a detrimental cascade of cell damage. In the acute stage of subarachnoid hemorrhage (SAH), a sequence of global and focal ischemia occurs, threatening brain tissue to undergo ischemic damage. This study was conducted to investigate whether early therapy with moderate hypothermia can offer neuroprotection after experimental SAH. MATERIALS AND METHODS: 20 male Sprague-Dawley rats were subjected to SAH and treated by active cooling (34° C) or served as controls by continuous maintenance of normothermia (37...
September 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28905773/re-continuous-normothermic-ex%C3%A2-vivo-kidney-perfusion-is-superior-to-brief-normothermic-perfusion-following-static-cold-storage-in-donation-after-circulatory-death-pig-kidney-transplantation
#18
https://www.readbyqxmd.com/read/28901972/normothermic-machine-perfusion-of-the-kidney
#19
Annemarie Weissenbacher, James Hunter
PURPOSE OF REVIEW: Normothermic machine perfusion (NMP) is a preservation method that is generating increasing interest. The aim of this review is to summarise the current status of NMP in regards of kidney viability assessment, reducing organ damage and improving transplant logistics. RECENT FINDINGS: The results of recent large animal experiments and clinical trials show that continuous prolonged normothermic ex-vivo kidney perfusion appears better than a brief period of NMP after static cold storage in terms of renal injury and function...
December 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28889600/normothermic-ex-vivo-kidney-perfusion-for-graft-quality-assessment-prior-to-transplantation
#20
J Moritz Kaths, Mátyás Hamar, Juan Echeverri, Ivan Linares, Peter Urbanellis, Jun Yu Cen, Sujani Ganesh, Luke S Dingwell, Paul Yip, Rohan John, Darius Bagli, Istvan Mucsi, Anand Ghanekar, David Grant, Lisa A Robinson, Markus Selzner
Normothermic ex vivo kidney perfusion (NEVKP) represents a novel approach for graft preservation and functional improvement in kidney transplantation. We investigated whether NEVKP also allows graft quality assessment before transplantation. Kidneys from 30-kg pigs were recovered in a model of heart-beating donation (group A) after 30 minutes (group B) or 60 minutes (group C) (n = 5/group) of warm ischemia. After 8 hours of NEVKP, contralateral kidneys were resected, grafts were autotransplanted, and the pigs were followed for 3 days...
September 10, 2017: American Journal of Transplantation
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