Journal
BIOMOLECULES
Volume 11, Issue 3, Pages -Publisher
MDPI
DOI: 10.3390/biom11030446
Keywords
AP39; hydrogen sulfide; subnormothermic perfusion; kidney preservation; ischemia-reperfusion injury; donation after cardiac death; porcine model
Categories
Funding
- Physicians Services Incorporated (PSI) Foundation [1817]
- Lawson Research Institute
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Cold preservation is the standard care for renal grafts, but research on alternatives like perfusion at higher temperatures and supplementing preservation solutions with hydrogen sulfide (H2S) has shown promising results. This study found that subnormothermic perfusion at 21 degrees C with H2S-supplemented blood improved renal graft outcomes, as indicated by increased urine output, reduced apoptotic injury, and changes in pro-survival gene expression patterns. Further research is needed for the clinical translation of this approach.
Cold preservation is the standard of care for renal grafts. However, research on alternatives like perfusion at higher temperatures and supplementing preservation solutions with hydrogen sulfide (H2S) has gained momentum. In this study, we investigated whether adding H2S donor AP39 to porcine blood during subnormothermic perfusion at 21 degrees C improves renal graft outcomes. Porcine kidneys were nephrectomized after 30 min of clamping the renal pedicles and treated to 4 h of static cold storage (SCS) on ice or ex vivo subnormothermic perfusion at 21 degrees C with autologous blood alone (SNT) or with AP39 (SNTAP). All kidneys were reperfused ex vivo with autologous blood at 37 degrees C for 4 h. Urine output, histopathology and RNAseq were used to evaluate the renal graft function, injury and gene expression profiles, respectively. The SNTAP group exhibited significantly higher urine output than other groups during preservation and reperfusion, along with significantly lower apoptotic injury compared to the SCS group. The SNTAP group also exhibited differential pro-survival gene expression patterns compared to the SCS (downregulation of pro-apoptotic genes) and SNT (downregulation of hypoxia response genes) groups. Subnormothermic perfusion at 21 degrees C with H2S-supplemented blood improves renal graft outcomes. Further research is needed to facilitate the clinical translation of this approach.
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