Prolonged Normothermic Ex Vivo Kidney Perfusion Is Superior to Cold Nonoxygenated and Oxygenated Machine Perfusion for the Preservation of DCD Porcine Kidney Grafts.

Autor:	Mazilescu LI; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.; Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Urbanellis P; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Institute of Medical Science, University of Toronto, Toronto, ON, Canada., Kaths MJ; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Ganesh S; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Goto T; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Noguchi Y; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., John R; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.; Department of Pathology, University Health Network, Toronto, ON, Canada., Konvalinka A; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.; Multi-Organ Transplant Program, Division of Nephrology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Mucsi I; Multi-Organ Transplant Program, Division of Nephrology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Ghanekar A; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Bagli DJ; Department of Urology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., Turgeon J; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada., Karakeusian Rimbaud A; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada., Hébert MJ; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.; Université de Montréal, Montréal, QC, Canada., Dieudé M; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.; Université de Montréal, Montréal, QC, Canada., Alleys I; Département de Microbiologie et Immunologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada., Dore E; Département de Microbiologie et Immunologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada., Boilard E; Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.; Département de Microbiologie et Immunologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada., Overkleeft HS; Department of Bioorganic Synthesis, Leiden University, Leiden, The Netherlands., Willems LI; Department of Chemistry, The University of York, York, United Kingdom., Robinson LA; Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.; Program in Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON, Canada., Selzner M; Multi-Organ Transplant Program, Division of General Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2021 Sep 07; Vol. 7 (10), pp. e751. Date of Electronic Publication: 2021 Sep 07 (Print Publication: 2021).
DOI:	10.1097/TXD.0000000000001218
Abstrakt:	The increased usage of marginal grafts has triggered interest in perfused kidney preservation to minimize graft injury. We used a donation after circulatory death (DCD) porcine kidney autotransplantation model to compare 3 of the most frequently used ex vivo kidney perfusion techniques: nonoxygenated hypothermic machine perfusion (non-oxHMP), oxygenated hypothermic machine perfusion (oxHMP), and normothermic ex vivo kidney perfusion (NEVKP). Methods: Following 30 min of warm ischemia, grafts were retrieved and preserved with either 16 h of non-oxHMP, oxHMP, or NEVKP (n = 5 per group). After contralateral nephrectomy, grafts were autotransplanted and animals were followed for 8 d. Kidney function and injury markers were compared between groups. Results: NEVKP demonstrated a significant reduction in preservation injury compared with either cold preservation method. Grafts preserved by NEVKP showed superior function with lower peak serum creatinine (NEVKP versus non-oxHMP versus oxHMP: 3.66 ± 1.33 mg/dL, 8.82 ± 3.17 mg/dL, and 9.02 ± 5.5 mg/dL) and more rapid recovery. The NEVKP group demonstrated significantly increased creatinine clearance on postoperative day 3 compared with the cold perfused groups. Tubular injury scores on postoperative day 8 were similar in all groups. Conclusions: Addition of oxygen during HMP did not reduce preservation injury of DCD kidney grafts. Grafts preserved with prolonged NEVKP demonstrated superior initial graft function compared with grafts preserved with non-oxHMP or oxHMP in a model of pig DCD kidney transplantation. Competing Interests: The authors of this article declare no conflicts of interest. (Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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