A pilot study assessing the feasibility of a short period of normothermic preservation in an experimental model of non heart beating donor kidneys.

S. A. Hosgood*, A. D. Barlow, P. J. Yates, M.G. Snoeijs, L.W.E. van Heurn, M.L. Nicholson

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Restoring metabolism to an organ after hypothermic storage and before transplantation could reverse some of the detrimental effects of ischemic injury. This may be particularly beneficial for kidneys from non-heart-beating (NHBD) donors that sustain significant periods of warm and cold ischemic injury. This pilot study assessed the feasibility of a short period of normothermic preservation (NP) in a porcine autotransplant model. METHODS: Kidneys were subjected to 30 min of warm ischemia, then preserved by hypothermic machine perfusion (HMP) for 22 h or 20 h HMP followed by 2 h of NP using autologous blood. Kidneys were then re-implanted, a contralateral nephrectomy performed, and renal function measured over 10 d. RESULTS: Post-transplant, 4/6 animals survived in the NP group compared with 5/6 in the HMP group (P = 1.00). Creatinine levels fell below 250 mumol/L in all four of the surviving animals in the NP group compared with 2/5 in the HMP group (P = 0.608). There was no difference in levels of renal function (peak creatinine, HMP= 1736 +/- 866 versus NP =1553 +/- 516 mumol/L; P >/= 0.990). Levels of lipid peroxidation were significantly lower 60 min post-transplant in the NP group (NP = 477 +/- 118.0 versus HMP = 671 +/- 99.4 pg/mL; P = 0.026). CONCLUSION: A period of NP at the end of the renal preservation period in NHB kidneys is a feasible method of kidney preservation. NP could prove to be a useful technique to predetermine graft function and allow pre-transplant modification of organs.
Original languageEnglish
Pages (from-to)283-290
Number of pages8
JournalJournal of Surgical Research
Volume171
Issue number1
DOIs
Publication statusPublished - Nov 2011

Keywords

  • hypothermic
  • ischemia
  • kidney
  • non-heart-beating donor
  • normothermic
  • preservation
  • porcine
  • DELAYED GRAFT FUNCTION
  • RENAL-TRANSPLANTATION
  • MACHINE PERFUSION
  • REPERFUSION INJURY
  • COLD-STORAGE
  • ISCHEMIA
  • WARM
  • BIOMARKERS
  • SURVIVAL
  • SYSTEM

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