Novel portable hypothermic pulsatile perfusion preservation technology: Improved viability and function of rodent and canine kidneys.

ABSTRACT

BACKGROUND: A reliable, portable, cost effective device for perfusion preservation of donor organs remains elusive. A portable, organ perfusion device design for hypothermic, machine perfusion (HMP) that successfully supported rodent kidneys for 24 hours was evaluated in canine kidneys. MATERIAL/METHODS: Freshly recovered rodent and canine kidneys were subjected to 24 hours of HMP or static storage (SS). Organ perfusion and cell membrane integrity were examined in HMP and SS rodent kidneys. Canine kidney function was evaluated in an isolated organ preparation. Oxygen consumption (OC), renal vascular resistance (RVR), and glomerular filtration rates (GFR) were compared. RESULTS: Perfusion pressure during HMP averaged 16 mmHg with oxygen delivery roughly 4 fold greater than the canine kidney's metabolic requirements. Following 24 hours of preservation, RVR was significantly elevated while OC and GFR were significantly lower in the SS organs compared to the HMP stored or freshly recovered kidneys. CONCLUSIONS: This organ preservation technology appears to provide an excellent preservation environment for kidneys such that post-transplant delayed graft function is minimized. Additionally, compared to current machine perfusion systems, the preservation system described in this work is significantly reduced in size, weight, and complexity, such that total portability may be possible.