Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys.


Journal

Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 22 04 2020
revised: 27 04 2020
accepted: 28 04 2020
entrez: 9 8 2020
pubmed: 9 8 2020
medline: 9 8 2020
Statut: epublish

Résumé

The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model. The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO

Sections du résumé

BACKGROUND BACKGROUND
The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model.
METHODS METHODS
The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO
RESULTS RESULTS
Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po
CONCLUSIONS CONCLUSIONS
The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO

Identifiants

pubmed: 32766426
doi: 10.1097/TXD.0000000000001016
pmc: PMC7339262
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e571

Informations de copyright

Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The LifePort Kidney Transporter, the perfusion circuits, and the oxygenators were supplied by Organ Recovery Systems (Diegem, Belgium). T.D. received a grant from the “Fondation Saint Luc,” the “Fondation Recherche Clinique,” and Astellas Pharma BV Belgium and logistic support from Organ Recovery Systems. The other authors declare no conflicts of interest.

Références

Nature. 2014 Nov 20;515(7527):431-435
pubmed: 25383517
Circulation. 2003 May 6;107(17):2168-70
pubmed: 12732590
Kidney Int. 2016 Jun;89(6):1331-6
pubmed: 27165823
Anaesthesia. 2006 Oct;61(10):984-95
pubmed: 16978315
Transpl Int. 2010 May 1;23(5):538-42
pubmed: 19951372
Transplantation. 2012 Apr 27;93(8):787-93
pubmed: 22441320
Am J Transplant. 2015 Jan;15(1):161-9
pubmed: 25521639
J Surg Res. 2011 May 15;167(2):e365-73
pubmed: 20451921
Am J Transplant. 2015 Jun;15(6):1632-43
pubmed: 25707303
Cell Metab. 2016 Feb 9;23(2):254-63
pubmed: 26777689
Am J Transplant. 2017 Jan;17(1):140-150
pubmed: 27333454
J Surg Res. 2013 Oct;184(2):1174-81
pubmed: 23731682
Kidney Int. 2014 Aug;86(2):251-8
pubmed: 24522494
Am J Transplant. 2020 Aug;20(8):2030-2043
pubmed: 32012434
Perfusion. 2008 Jan;23(1):39-42
pubmed: 18788216
Kidney Int. 1997 Feb;51(2):381-5
pubmed: 9027710
Ann Surg. 2016 Nov;264(5):815-822
pubmed: 27584571
Transplantation. 2019 Feb;103(2):412-419
pubmed: 29762458
J Transl Med. 2015 Oct 16;13:329
pubmed: 26474973
Am J Transplant. 2019 Mar;19(3):752-762
pubmed: 30171799
Transplantation. 2014 Nov 15;98(9):944-50
pubmed: 25369373
Transplantation. 2019 Feb;103(2):314-322
pubmed: 30461718
Transplantation. 2019 Oct;103(10):1980-1981
pubmed: 31283667
Transplantation. 2004 Apr 27;77(8):1264-8
pubmed: 15114096
Anal Chem. 2006 Sep 15;78(18):6573-82
pubmed: 16970336
Proc Natl Acad Sci U S A. 2019 Jan 22;116(4):1241-1250
pubmed: 30626647
J Biol Chem. 2018 Jun 22;293(25):9869-9879
pubmed: 29743240
MAGMA. 2012 Oct;25(5):391-9
pubmed: 22644411
Transplantation. 2020 Apr;104(4):731-743
pubmed: 31764761

Auteurs

Tom Darius (T)

Department of Surgery, Surgery and Abdominal Transplant Unit, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.

Martial Vergauwen (M)

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.

Matteo Mueller (M)

Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary Center, University Hospital Zurich, Zurich, Switzerland.

Selda Aydin (S)

Department of Pathology, University Clinics Saint Luc, Université Catholique de Louvain, Brussels, Belgium.

Philipp Dutkowski (P)

Department of Pathology, University Clinics Saint Luc, Université Catholique de Louvain, Brussels, Belgium.

Pierre Gianello (P)

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.

Michel Mourad (M)

Department of Surgery, Surgery and Abdominal Transplant Unit, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Chirurgie Expérimentale et Transplantation, Université Catholique de Louvain, Brussels, Belgium.

Classifications MeSH