Prolonged Normothermic Ex Vivo Kidney Perfusion Is Superior to Cold Nonoxygenated and Oxygenated Machine Perfusion for the Preservation of DCD Porcine Kidney Grafts. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Mazilescu, Laura I.; Urbanellis, Peter; Kaths, Moritz J.; Ganesh, Sujani; Goto, Toru; Noguchi, Yuki; John, Rohan; Konvalinka, Ana; Mucsi, Istvan; Ghanekar, Anand; Bagli, Darius J.; Turgeon, Julie; Karakeusian Rimbaud, Annie; Hébert, Marie-Josée; Dieudé, Mélanie; Alleys, Isabelle; Dore, Etienne; Boilard, Eric; Overkleeft, Herman S.; Willems, Lianne I.; Robinson, Lisa A.; Selzner, Markus
• Is Part Of: Transplantation direct. Volume 7:Issue 10(2021)
• Publication Date: 2021-10
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation -- Periodicals; 362.19795
• DOI: 10.1097/TXD.0000000000001218
• Languages: English
• ISSNs: 2373-8731

Abstract

Abstract : Background: The increased usage of marginal grafts has triggered interest in perfused kidney preservation to minimize graft injury. We used a donation after circulatory death (DCD) porcine kidney autotransplantation model to compare 3 of the most frequently used ex vivo kidney perfusion techniques: nonoxygenated hypothermic machine perfusion (non-oxHMP), oxygenated hypothermic machine perfusion (oxHMP), and normothermic ex vivo kidney perfusion (NEVKP). Methods: Following 30 min of warm ischemia, grafts were retrieved and preserved with either 16 h of non-oxHMP, oxHMP, or NEVKP (n = 5 per group). After contralateral nephrectomy, grafts were autotransplanted and animals were followed for 8 d. Kidney function and injury markers were compared between groups. Results: NEVKP demonstrated a significant reduction in preservation injury compared with either cold preservation method. Grafts preserved by NEVKP showed superior function with lower peak serum creatinine (NEVKP versus non-oxHMP versus oxHMP: 3.66 ± 1.33 mg/dL, 8.82 ± 3.17 mg/dL, and 9.02 ± 5.5 mg/dL) and more rapid recovery. The NEVKP group demonstrated significantly increased creatinine clearance on postoperative day 3 compared with the cold perfused groups. Tubular injury scores on postoperative day 8 were similar in all groups. Conclusions: Addition of oxygen during HMP did not reduce preservation injury of DCD kidney grafts. Grafts preserved with prolonged NEVKP demonstrated superior initial graft function compared with grafts preserved with non-oxHMP or oxHMP in a model of pig DCD kidney transplantation.