Synthetic hemoglobin‐based oxygen carriers are an acceptable alternative for packed red blood cells in normothermic kidney perfusion. Issue 10 (26th April 2019)

• Record Type: Journal Article
• Authors: Aburawi, Mohamed M.; Fontan, Fermin M.; Karimian, Negin; Eymard, Corey; Cronin, Stephanie; Pendexter, Casie; Nagpal, Sonal; Banik, Peony; Ozer, Sinan; Mahboub, Paria; Delmonico, Francis L.; Yeh, Heidi; Uygun, Korkut; Markmann, James F.
• Is Part Of: American journal of transplantation. Volume 19:Issue 10(2019)
• Page Start: 2814
• Page End: 2824
• Publication Date: 2019-04-26
• Subjects: basic (laboratory) research/science -- kidney transplantation/nephrology -- organ perfusion and preservation -- organ procurement and allocation -- tissue/organ engineering -- translational research/science; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.15375
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Normothermic machine perfusion presents a novel platform for pretransplant assessment and reconditioning of kidney grafts. Maintaining the metabolic activity of a preserved graft at physiologic levels requires an adequate oxygen supply, typically delivered by crystalloid solutions supplemented with red blood cells. In this study, we explored the feasibility of using a synthetic hemoglobin‐based oxygen carrier (HBOC) in human kidney normothermic perfusion. Fourteen discarded human kidneys were perfused for 6 hours at a mean temperature of 37°C using a pressure‐controlled system. Kidneys were perfused with a perfusion solution supplemented with either HBOC (n = 7) or packed red blood cells (PRBC) (n = 7) to increase oxygen‐carrying capacity. Renal artery resistance, oxygen extraction, metabolic activity, energy stores, and histological features were evaluated. Throughout perfusion, kidneys from both groups exhibited comparable behavior regarding vascular flow ( P = .66), oxygen consumption ( P = .88), and reconstitution of tissue adenosine triphosphate ( P = .057). Lactic acid levels were significantly higher in kidneys perfused with PRBC ( P = .007). Histological findings were comparable between groups, and there was no evidence of histological damage caused by the HBOC. This feasibility experiment demonstrates that a HBOC solution can offer a logistically more convenient off‐the‐shelf alternative to PRBC in normothermic machine perfusion of human kidneys. Abstract : An acellular oxygen carrier performs similarly to packed red blood cells during normothermic machine perfusion of human kidneys.