Extra-corporeal normothermic machine perfusion of the porcine kidney: working towards future utilization in Australasia.
ANZ J Surg
; 88(5): E429-E434, 2018 May.
Article
in En
| MEDLINE
| ID: mdl-29239091
ABSTRACT
BACKGROUND:
The ongoing supply-demand gap with respect to donor kidneys for transplantation necessitates the increased use of higher kidney donor profile index and/or donation after circulatory death (DCD) kidneys. Machine perfusion (MP) preservation has become increasingly popular as a means to preserve such organs. Human data regarding normothermic kidney MP (NMP) is in its infancy, and such a system has not been established in the Australasian clinical setting.METHODS:
Modified cardio-pulmonary bypass technology was utilized to develop a viable NMP kidney perfusion system using a porcine DCD model. System development and optimization occurred in two stages, with system components added in each experiment to identify optimal perfusion conditions.RESULTS:
Device functionality was demonstrated by the successful perfusion of and urine production by, eight porcine kidneys. Urine production diminished in the presence of colloid in the perfusate. Pressure-controlled (compared with flow-controlled) perfusion is preferable as a safe perfusion pressure range can be maintained. More physiologic perfusion conditions are achieved if oxygenation is provided by an oxygen/carbon dioxide mixture compared to 100% oxygen.CONCLUSION:
A viable and reproducible NMP system was established and tested in porcine kidneys, which was able to simulate graft function extra-corporeally. Further work is required to identify the most optimal perfusion conditions. Prior to its utilization in clinical transplantation, the system should be tested in non-transplanted human kidneys.Key words
Full text:
1
Collection:
01-internacional
Health context:
6_ODS3_enfermedades_notrasmisibles
Database:
MEDLINE
Main subject:
Organ Preservation
/
Perfusion
/
Kidney Transplantation
/
Tissue and Organ Harvesting
/
Extracorporeal Circulation
Limits:
Animals
Country/Region as subject:
Oceania
Language:
En
Journal:
ANZ J Surg
Year:
2018
Document type:
Article