Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition
| Autor: | Marius C. van den Heuvel, Henri G. D. Leuvenink, Cyril Moers, Tim L Hamelink, Harry van Goor, Merel B F Pool |
|---|---|
| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Physiology
Swine Thiobarbituric acid Vasodilation Urine 030230 surgery Kidney Biochemistry Electrolytes chemistry.chemical_compound 0302 clinical medicine Medicine and Health Sciences Electrochemistry Renal Transplantation 030212 general & internal medicine Multidisciplinary Organic Compounds Chemistry Monosaccharides Organ Preservation Body Fluids Perfusion Blood Creatinine Physical Sciences Medicine Anatomy Research Article medicine.medical_specialty Science Carbohydrates Urology Surgical and Invasive Medical Procedures Urinary System Procedures 03 medical and health sciences medicine Animals Transplantation Machine perfusion Organic Chemistry Chemical Compounds Albumin Biology and Life Sciences Kidneys Renal System Organ Transplantation Kidney Transplantation Glucose Biomarkers Ex vivo |
| Zdroj: | PLoS ONE, 16(5):e0251595. PUBLIC LIBRARY SCIENCE PLoS ONE, Vol 16, Iss 5, p e0251595 (2021) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Normothermic machine perfusion (NMP) of donor kidneys provides the opportunity for improved graft preservation and objective pre-transplant ex-vivo organ assessment. Currently, a multitude of perfusion solutions exist for renal NMP. This study aimed to evaluate four different perfusion solutions side-by-side and determine the influence of different perfusate compositions on measured renal perfusion parameters. Porcine kidneys and blood were obtained from a slaughterhouse. Kidneys underwent NMP at 37°C for 7 hours, with 4 different perfusion solutions (n = 5 per group). Group 1 consisted of red blood cells (RBCs) and a perfusion solution based on Williams’ Medium E. Group 2 consisted of RBCs, albumin and a balanced electrolyte composition. Group 3 contained RBCs and a medium based on a British clinical NMP solution. Group 4 contained RBCs and a medium used in 24-hour perfusion experiments. NMP flow patterns for solutions 1 and 2 were similar, solutions 3 and 4 showed lower but more stable flow rates. Thiobarbituric acid reactive substances were significantly higher in solution 1 and 4 compared to the other groups. Levels of injury marker N-acetyl-β-D glucosaminidase were significantly lower in solution 2 in comparison with solution 3 and 4. This study illustrates that the perfusate composition during NMP significantly impacts the measured perfusion and injury parameters and thus affects the interpretation of potential viability markers. Further research is required to investigate the individual influences of principal perfusate components to determine the most optimal conditions during NMP and eventually develop universal organ assessment criteria. |
| Databáze: | OpenAIRE |
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