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Normothermic Ex Vivo Kidney Perfusion Following Static Cold Storage-Brief, Intermediate, or Prolonged Perfusion for Optimal Renal Graft Reconditioning?
Kaths, J M; Echeverri, J; Linares, I; Cen, J Y; Ganesh, S; Hamar, M; Urbanellis, P; Yip, P; John, R; Bagli, D; Mucsi, I; Ghanekar, A; Grant, D; Robinson, L A; Selzner, M.
Afiliação
  • Kaths JM; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Echeverri J; Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Linares I; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
  • Cen JY; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Ganesh S; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Hamar M; Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Urbanellis P; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Yip P; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • John R; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Bagli D; Laboratory Medicine & Pathobiology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Mucsi I; Laboratory Medicine & Pathobiology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Ghanekar A; Departments of Surgery (Urology) & Physiology, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Grant D; Multi Organ Transplant Program, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Robinson LA; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Selzner M; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Am J Transplant ; 17(10): 2580-2590, 2017 Oct.
Article em En | MEDLINE | ID: mdl-28375588
ABSTRACT
Normothermic ex vivo kidney perfusion (NEVKP) demonstrated superior results compared to hypothermic storage in donation after circulatory death (DCD) kidney transplantation. It is unknown whether an optimal perfusion time exists following hypothermic storage to allow for the recovery of renal grafts from cold ischemic injury. In a porcine model of DCD kidney autotransplantation, the impact of initial static cold storage (SCS) (8 h) followed by various periods of NEVKP recovery was investigated group A, 8 hSCS only (control); group B, 8 hSCS + 1 hNEVKP (brief NEVKP); group C, 8 hSCS + 8 hNEVKP (intermediate NEVKP); and group D, 8 hSCS + 16 hNEVKP (prolonged NEVKP). All grafts were preserved and transplanted successfully. One animal in group D was sacrificed and excluded by postoperative day 3 due to hind limb paralysis, but demonstrated good renal function. Postoperative graft assessment during 8 days' follow-up demonstrated lowest levels of peak serum creatinine for intermediate (C) and prolonged (D) NEVKP (p = 0.027). Histological assessment on day 8 demonstrated a significant difference in tubular injury (p = 0.001), with highest values for group B. These results suggest that longer periods of NEVKP following SCS are feasible and safe for postponing surgical transplant procedure and superior to brief NEVKP, reducing the damage caused during cold ischemic storage of renal grafts.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Perfusão / Regulação da Temperatura Corporal / Transplante de Rim Limite: Animals / Humans / Male Idioma: En Revista: Am J Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Canadá
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Perfusão / Regulação da Temperatura Corporal / Transplante de Rim Limite: Animals / Humans / Male Idioma: En Revista: Am J Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Canadá