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Effects of Oxygen During Long-term Hypothermic Machine Perfusion in a Porcine Model of Kidney Donation After Circulatory Death.
Venema, Leonie H; Brat, Aukje; Moers, Cyril; 't Hart, Nils A; Ploeg, Rutger J; Hannaert, Patrick; Minor, Thomas; Leuvenink, And Henri G D.
Afiliação
  • Venema LH; Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
  • Brat A; Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
  • Moers C; Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
  • 't Hart NA; Department of Pathology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
  • Ploeg RJ; Department of Surgery, Nuffield Department of Surgical Science, University of Oxford, Oxford, United Kingdom.
  • Hannaert P; IRTOMIT, INSERM U1082, Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France.
  • Minor T; Department for Surgical Research/General Surgery, University Hospital Essen, Essen, Germany.
  • Leuvenink AHGD; Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Transplantation ; 103(10): 2057-2064, 2019 10.
Article em En | MEDLINE | ID: mdl-30951018
BACKGROUND: Hypothermic machine perfusion (HMP) has become standard care in many center's to preserve kidneys donated after circulatory death (DCD). Despite a significant reduction in metabolism at low temperatures, the remaining cellular activity requires oxygen. Because of the role and safety of oxygen during HMP has not been fully clarified, its supply during HMP is not standard yet. This study investigates the effect of administering oxygen during HMP on renal function in a porcine DCD model. METHODS: After 30 minutes of warm ischemia, porcine slaughterhouse kidneys were preserved for 24 hours by means of cold storage (CS), or HMP with Belzer Machine Perfusion Solution supplemented with no oxygen, 21% or 100% oxygen. Next, kidneys were reperfused for 4 hours in a normothermic machine perfusion setup. RESULTS: HMP resulted in significantly better kidney function during normothermic machine perfusion. Thiobarbituric acid-reactive substances, markers of oxidative stress, were significantly lower in HMP preserved kidneys. HMP preserved kidneys showed significantly lower aspartate aminotransferase and lactate dehydrogenase levels compared with kidneys preserved by CS. No differences were found between the HMP groups subjected to different oxygen concentrations. Adenosine triphosphate levels significantly improved during HMP when active oxygenation was applied. CONCLUSIONS: This study showed that preservation of DCD kidneys with HMP is superior to CS. Although the addition of oxygen to HMP did not result in significantly improved renal function, beneficial effects were found in terms of reduced oxidative stress and energy status. Oxygen addition proofed to be safe and did not show detrimental effects.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Oxigênio / Perfusão / Traumatismo por Reperfusão / Coleta de Tecidos e Órgãos / Hipotermia Induzida Tipo de estudo: Etiology_studies Limite: Animals / Humans Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Oxigênio / Perfusão / Traumatismo por Reperfusão / Coleta de Tecidos e Órgãos / Hipotermia Induzida Tipo de estudo: Etiology_studies Limite: Animals / Humans Idioma: En Ano de publicação: 2019 Tipo de documento: Article