Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.

Normothermic machine perfusion (NMP) of donor kidneys provides the opportunity for improved graft preservation and objective pre-transplant ex-vivo organ assessment. Currently, a multitude of perfusion solutions exist for renal NMP. This study aimed to evaluate four different perfusion solutions sid...

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Autores principales:	Merel B F Pool, Tim L Hamelink, Harry van Goor, Marius C van den Heuvel, Henri G D Leuvenink, Cyril Moers
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e42573aac7ab4b489296dc1f21abb734
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spelling	oai:doaj.org-article:e42573aac7ab4b489296dc1f21abb7342021-11-25T05:54:15ZProlonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.1932-620310.1371/journal.pone.0251595https://doaj.org/article/e42573aac7ab4b489296dc1f21abb7342021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251595https://doaj.org/toc/1932-6203Normothermic machine perfusion (NMP) of donor kidneys provides the opportunity for improved graft preservation and objective pre-transplant ex-vivo organ assessment. Currently, a multitude of perfusion solutions exist for renal NMP. This study aimed to evaluate four different perfusion solutions side-by-side and determine the influence of different perfusate compositions on measured renal perfusion parameters. Porcine kidneys and blood were obtained from a slaughterhouse. Kidneys underwent NMP at 37°C for 7 hours, with 4 different perfusion solutions (n = 5 per group). Group 1 consisted of red blood cells (RBCs) and a perfusion solution based on Williams' Medium E. Group 2 consisted of RBCs, albumin and a balanced electrolyte composition. Group 3 contained RBCs and a medium based on a British clinical NMP solution. Group 4 contained RBCs and a medium used in 24-hour perfusion experiments. NMP flow patterns for solutions 1 and 2 were similar, solutions 3 and 4 showed lower but more stable flow rates. Thiobarbituric acid reactive substances were significantly higher in solution 1 and 4 compared to the other groups. Levels of injury marker N-acetyl-β-D glucosaminidase were significantly lower in solution 2 in comparison with solution 3 and 4. This study illustrates that the perfusate composition during NMP significantly impacts the measured perfusion and injury parameters and thus affects the interpretation of potential viability markers. Further research is required to investigate the individual influences of principal perfusate components to determine the most optimal conditions during NMP and eventually develop universal organ assessment criteria.Merel B F PoolTim L HamelinkHarry van GoorMarius C van den HeuvelHenri G D LeuveninkCyril MoersPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251595 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Merel B F Pool Tim L Hamelink Harry van Goor Marius C van den Heuvel Henri G D Leuvenink Cyril Moers Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
description	Normothermic machine perfusion (NMP) of donor kidneys provides the opportunity for improved graft preservation and objective pre-transplant ex-vivo organ assessment. Currently, a multitude of perfusion solutions exist for renal NMP. This study aimed to evaluate four different perfusion solutions side-by-side and determine the influence of different perfusate compositions on measured renal perfusion parameters. Porcine kidneys and blood were obtained from a slaughterhouse. Kidneys underwent NMP at 37°C for 7 hours, with 4 different perfusion solutions (n = 5 per group). Group 1 consisted of red blood cells (RBCs) and a perfusion solution based on Williams' Medium E. Group 2 consisted of RBCs, albumin and a balanced electrolyte composition. Group 3 contained RBCs and a medium based on a British clinical NMP solution. Group 4 contained RBCs and a medium used in 24-hour perfusion experiments. NMP flow patterns for solutions 1 and 2 were similar, solutions 3 and 4 showed lower but more stable flow rates. Thiobarbituric acid reactive substances were significantly higher in solution 1 and 4 compared to the other groups. Levels of injury marker N-acetyl-β-D glucosaminidase were significantly lower in solution 2 in comparison with solution 3 and 4. This study illustrates that the perfusate composition during NMP significantly impacts the measured perfusion and injury parameters and thus affects the interpretation of potential viability markers. Further research is required to investigate the individual influences of principal perfusate components to determine the most optimal conditions during NMP and eventually develop universal organ assessment criteria.
format	article
author	Merel B F Pool Tim L Hamelink Harry van Goor Marius C van den Heuvel Henri G D Leuvenink Cyril Moers
author_facet	Merel B F Pool Tim L Hamelink Harry van Goor Marius C van den Heuvel Henri G D Leuvenink Cyril Moers
author_sort	Merel B F Pool
title	Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
title_short	Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
title_full	Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
title_fullStr	Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
title_full_unstemmed	Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.
title_sort	prolonged ex-vivo normothermic kidney perfusion: the impact of perfusate composition.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e42573aac7ab4b489296dc1f21abb734
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Prolonged ex-vivo normothermic kidney perfusion: The impact of perfusate composition.

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