A comparison of pulsatile hypothermic and normothermic ex vivo machine perfusion in a porcine kidney model
N Vallant, N Wolfhagen, B Sandhu, K Hamaoui… - …, 2021 - journals.lww.com
N Vallant, N Wolfhagen, B Sandhu, K Hamaoui, T Cook, C Pusey, V Papalois
Transplantation, 2021•journals.lww.comBackground. Hypothermic machine perfusion (HMP) is a well-established method for
deceased donor kidney preservation. Normothermic machine perfusion (NMP) might offer
similar or greater advantages. We compared the 2 methods in an ex vivo perfusion model
using 34 porcine kidneys. Methods. Thirty kidneys were stored on ice for 24 h before
undergoing 4 h of HMP (n= 15) or NMP (n= 15) followed by 2 h of normothermic ex vivo
reperfusion with whole blood. Four kidneys underwent 28 h of cold static storage followed by …
deceased donor kidney preservation. Normothermic machine perfusion (NMP) might offer
similar or greater advantages. We compared the 2 methods in an ex vivo perfusion model
using 34 porcine kidneys. Methods. Thirty kidneys were stored on ice for 24 h before
undergoing 4 h of HMP (n= 15) or NMP (n= 15) followed by 2 h of normothermic ex vivo
reperfusion with whole blood. Four kidneys underwent 28 h of cold static storage followed by …
Abstract
Background.
Hypothermic machine perfusion (HMP) is a well-established method for deceased donor kidney preservation. Normothermic machine perfusion (NMP) might offer similar or greater advantages. We compared the 2 methods in an ex vivo perfusion model using 34 porcine kidneys.
Methods.
Thirty kidneys were stored on ice for 24 h before undergoing 4 h of HMP (n= 15) or NMP (n= 15) followed by 2 h of normothermic ex vivo reperfusion with whole blood. Four kidneys underwent 28 h of cold static storage followed by 2 h of normothermic ex vivo reperfusion. During the 2 h of normothermic ex vivo reperfusion, perfusate flow rates, urinary output, and oxygen consumption rates were compared between all groups.
Results.
Porcine kidneys after HMP showed significantly higher urinary output (5.31±2.06 versus 2.44±1.19 mL/min; P= 0.002), oxygen consumption (22.71±6.27 versus 11.83±1.29 mL/min; P= 0.0016), and perfusate flow rates (46.24±12.49 versus 26.16±4.57 mL/min; P= 0.0051) than kidneys after NMP. TUNEL staining of tissue sections showed significantly higher rates of apoptosis in kidneys after NMP (P= 0.027).
Conclusions.
In our study, the direct comparison of HMP and NMP kidney perfusion in a translational model demonstrated superiority of HMP; however, further in vivo studies would be needed to validate those results.
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