Purpose. Kidneys from DCD donors represent a significant pool, but preservation problems exist. The study objective was to test the importance of machine type for hypothermic preservation of DCD kidneys. Methods. Adult Beagle dog kidneys underwent 45 minutes of warm in situ ischemia followed by hypothermic perfusion for 24 hours (Belzer-MPS Solution) on either an ORS LifePort or a Waters RM3 using standard perfusion protocols. Kidneys were then autotransplanted, and renal function was assessed over 7 days following contralateral nephrectomy. Results. Renal vascular resistance was not different between the two pumps. After 24 hours, the oxygen partial pressure and oxygen delivery in the LifePort perfusate were significantly lower than those in the RM3 but not low enough to change lactate production. TheLifePort ran significantly colder than RM3 (2° versus 5°C). The arterial pressure waveform of the RM3 was qualitatively different from the waveform of the LifePort. Preservation injury after transplantation was not different between the devices. When the LifePort was changed to nonpulsatile flow, kidneys displayed significantly greater preservation injury compared to RM3. Conclusions. Both LifePort and RM3 can be used for hypothermic machine perfusion preservation of DCD kidneys with equal outcomes as long as the duty cycle remains pulsatile.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810436 | PMC |
| http://dx.doi.org/10.1155/2013/802618 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The 2024 American Association for Thoracic Surgery expert consensus document: Current standards in donor lung procurement and preservation.
J Thorac Cardiovasc Surg
February 2025
Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure.
View Article and Find Full Text PDFA Novel Machine Perfusion System for Enhancing Hepatic Microcirculation Perfusion.
Artif Organs
December 2024
Hubei Provincial Clinical Research Center for Natural Polymer Biological Liver, Hubei Key Laboratory of Medical Technology on Transplantation, National Quality Control Center for Donated Organ Procurement, Transplant Center of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Background: Machine perfusion is a promising strategy for safeguarding liver transplants donated after cardiac death (DCD). In this study, we developed and validated a novel machine perfusion approach for mitigating risk factors and salvaging severe DCD livers.
Methods: A novel hypothermic oxygenated perfusion (HOPE) system was developed, incorporating two pumps and an elastic water sac to emulate the functionality of the cardiac cycle.
Mitochondrial transplantation normalizes transcriptomic and proteomic shift associated with ischemia reperfusion injury in neonatal hearts donated after circulatory death.
Sci Rep
December 2024
Department of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Heart transplantation remains the ultimate treatment strategy for neonates and children with medically refractory end-stage heart failure and utilization of donors after circulatory death (DCD) can expand th donor pool. We have previously shown that mitochondrial transplantation preserves myocardial function and viability in neonatal swine DCD hearts to levels similar to that observed in donation after brain death (DBD). Herein, we sought to investigate the transcriptomic and proteomic pathways implicated in these phenotypic changes using ex situ perfused swine hearts.
View Article and Find Full Text PDFImpact of donor obesity on outcomes of donation after circulatory death heart transplantation.
J Thorac Cardiovasc Surg
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Va.
Background: In the setting of the obesity epidemic and donor organ shortage in the United States, there is a growing need to expand the donor organ eligibility criteria for orthotopic heart transplantation (OHT). Donation after circulatory death (DCD) has emerged as a promising solution, but the outcomes with obese donor hearts in DCD OHT remains unknown.
Methods: Using the United Network for Organ Sharing registry between 2019 and 2024, recipients of DCD OHT were stratified into 3 donor obesity categories by body mass index (BMI): underweight/normal (BMI <25 kg/m), overweight (BMI 25-30 kg/m), and obese (BMI >30 kg/m).
Transforming the logistics of liver transplantation with normothermic machine perfusion: Clinical impact versus cost.
Liver Transpl
December 2024
Duke Transplant Center, Duke University Medical Center, Durham, NC, USA.
Normothermic machine perfusion (NMP) facilitates utilization of marginal liver allografts. It remains unknown whether clinical benefits offset additional costs in the real-world setting. We performed a comparison of outcomes and hospitalization costs for donor livers preserved by NMP versus static cold storage (SCS) at a high-volume center.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!