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Antegrade persufflation of porcine kidneys improves renal function after warm ischemia.

Authors :
Min C
Galons JP
Lynch RM
Steyn LV
Price ND
Weegman BP
Taylor MJ
Pandey A
Harland R
Martin D
Besselsen D
Putnam CW
Papas KK
Source :
Frontiers in transplantation [Front Transplant] 2024 Aug 22; Vol. 3, pp. 1420693. Date of Electronic Publication: 2024 Aug 22 (Print Publication: 2024).
Publication Year :
2024

Abstract

Introduction: Transplantation of kidneys from expanded criteria donors (ECD), including after circulatory death (DCD), is associated with a higher risk of adverse events compared to kidneys from standard criteria donors. In previous studies, improvements in renal transplant outcomes have been seen when kidneys were perfused with gaseous oxygen during preservation (persufflation, PSF). In the present study, we assessed ex-vivo renal function from a Diffusion Contrast Enhanced (DCE)-MRI estimation of glomerular filtration rate (eGFR); and metabolic sufficiency from whole-organ oxygen consumption (WOOCR) and lactate production rates.<br />Methods: Using a porcine model of DCD, we assigned one kidney to antegrade PSF, and the contralateral kidney to static cold storage (SCS), both maintained for 24 h at 4°C. Post-preservation organ quality assessments, including eGFR, WOOCR and lactate production, were measured under cold perfusion conditions, and biopsies were subsequently taken for histopathological analysis.<br />Results: A significantly higher eGFR (36.6 ± 12.1 vs. 11.8 ± 4.3 ml/min, p  < 0.05), WOOCR (182 ± 33 vs. 132 ± 21 nmol/min*g, p  < 0.05), and lower rates of lactate production were observed in persufflated kidneys. No overt morphological differences were observed between the two preservation methods.<br />Conclusion: These data suggest that antegrade PSF is more effective in preserving renal function than conventional SCS. Further studies in large animal models of transplantation are required to investigate whether integration with PSF of WOOCR, eGFR or lactate production measurements before transplantation are predictive of post-transplantation renal function and clinical outcomes.<br />Competing Interests: BW and MT formed Sylvatica Biotech, Inc., after the investigations reported herein were completed. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.<br /> (© 2024 Min, Galons, Lynch, Steyn, Price, Weegman, Taylor, Pandey, Harland, Martin, Besselsen, Putnam and Papas.)

Details

Language :
English
ISSN :
2813-2440
Volume :
3
Database :
MEDLINE
Journal :
Frontiers in transplantation
Publication Type :
Academic Journal
Accession number :
39239359
Full Text :
https://doi.org/10.3389/frtra.2024.1420693