期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 17, 期 4, 页码 957-969出版社
WILEY
DOI: 10.1111/ajt.14059
关键词
basic (laboratory) research; science; translational research; science; kidney transplantation; nephrology; organ transplantation in general; regenerative medicine; animal models: porcine; autotransplantation; donors and donation: donation after circulatory death (DCD); organ perfusion and preservation; tissue injury and repair
资金
- LivaNova PLC (London, UK)
- XVIVO Perfusion Inc. (Goteborg, Sweden)
- Novartis
- Braun AG (Melsungen, Germany)
- John David and Signy Eaton Foundation
Hypothermic preservation is known to cause renal graft injury, especially in donation after circulatory death (DCD) kidney transplantation. We investigated the impact of cold storage (SCS) versus short periods of normothermic ex vivo kidney perfusion (NEVKP) after SCS versus prolonged, continuous NEVKP with near avoidance of SCS on kidney function after transplantation. Following 30 min of warm ischemia, kidneys were removed from 30-kg Yorkshire pigs and preserved for 16 h with (A) 16 h SCS, (B) 15 h SCS + 1 h NEVKP, (C) 8 h SCS + 8 h NEVKP, and (D) 16 h NEVKP. After contralateral kidney resection, grafts were autotransplanted and pigs followed up for 8 days. Perfusate injury markers such as aspartate aminotransferase and lactate dehydrogenase remained low; lactate decreased significantly until end of perfusion in groups C and D (p < 0.001 and p = 0.002). Grafts in group D demonstrated significantly lower serum creatinine peak when compared to all other groups (p < 0.001) and 24-h creatinine clearance at day 3 after surgery was significantly higher (63.4 19.0 mL/min) versus all other groups (p < 0.001). Histological assessment on day 8 demonstrated fewer apoptotic cells in group D (p = 0.008). In conclusion, prolonged, continuous NEVKP provides superior short-term outcomes following DCD kidney transplantation versus SCS or short additional NEVKP following SCS.
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