scholarly journals Normothermic machine perfusion for the assessment and transplantation of declined human kidneys from donation after circulatory death donors

2017 ◽  
Vol 105 (4) ◽  
pp. 388-394 ◽  
Author(s):  
S. A. Hosgood ◽  
E. Thompson ◽  
T. Moore ◽  
C. H. Wilson ◽  
M. L. Nicholson
Keyword(s):  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Normothermic Machine Perfusion ◽  
Circulatory Death

scholarly journals Normothermic Ex Vivo Machine Perfusion for Liver Grafts Recovered from Donors after Circulatory Death: A Systematic Review and Meta-Analysis

HPB Surgery ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jordan J. Nostedt ◽  
Daniel T. Skubleny ◽  
A. M. James Shapiro ◽  
Sandra Campbell ◽  
Darren H. Freed ◽  
...  
Keyword(s):  
Cold Storage ◽  
Meta Analysis ◽  
Mean Difference ◽  
Large Animal ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Economic Implications ◽  
Normothermic Perfusion ◽  
Normothermic Machine Perfusion ◽  
Circulatory Death

As a result of donation after circulatory death liver grafts’ poor tolerance to cold storage, there has been increasing research interest in normothermic machine perfusion. This study aims to systematically review the current literature comparing normothermic perfusion to cold storage in donation after circulatory death liver grafts and complete a meta-analysis of published large animal and human studies. A total of nine porcine studies comparing cold storage to normothermic machine perfusion for donation after circulatory death grafts were included for analysis. There was a significant reduction in AST (mean difference −2291 U/L, CI (−3019, −1563); P ≤ 0.00001) and ALT (mean difference −175 U/L, CI (−266, −85); P=0.0001), for normothermic perfusion relative to static cold storage, with moderate (I2 = 61%) and high (I2 = 96%) heterogeneity, respectively. Total bile production was also significantly higher (mean difference = 174 ml, CI (155, 193); P≤0.00001). Further research focusing on standardization, performance of this technology following periods of cold storage, economic implications, and clinical trial data focused on donation after circulatory death grafts will be helpful to advance this technology toward routine clinical utilization for these grafts.

scholarly journals Cytochrome P450 2E1 Predicts Liver Retrieval from Donation After Circulatory Death Using Air-Ventilated Normothermic Machine Perfusion

2021 ◽  
Author(s):  
Ji-Hua Shi ◽  
Dong-Jing Yang ◽  
Qiang Jin ◽  
Nuo Cheng ◽  
Yuan-Bin Shi ◽  
...  
Keyword(s):  
Cytochrome P450 ◽  
Ex Vivo ◽  
Liver Perfusion ◽  
Molecular Networks ◽  
Machine Perfusion ◽  
Cytochrome P450 2E1 ◽  
Donation After Circulatory Death ◽  
Pparγ Agonist ◽  
Normothermic Machine Perfusion ◽  
Circulatory Death

Abstract The optimal oxygen concentration is unclear for normothermic machine perfusion (NMP) of livers from donation after circulatory death donors (DCD). Our purposes were to investigate the effect of air-ventilated NMP on liver retrieval from DCD rats, and to analyze the underlying mechanism. Normothermic liver perfusion was performed using the NMP system with either air ventilation or oxygen ventilation for 2h in the rat liver following warm ischemia and cold ischemia preservation. Proteomics and metabolomics were used to reveal the significant molecular networks. The bioinformation analysis was validated by administering peroxisome proliferator activator receptor-γ (PPARγ) antagonist and agonist via ex vivo perfusion circuit in the air-ventilated NMP. Results showed that air-ventilated NMP conferred a better functional retrieval and a less inflammatory response in the rat DCD liver; integrated proteomics and metabolomics analysis indicated that intrahepatic docosapentaenoic acid (DPA) downregulation and upregulation of cytochrome P450 2E1 (CYP2E1) expression and activity were associated with DCD liver retrieval with air-ventilated NMP; PPARγ antagonist worsened liver function under air-oxygenated NMP whereas PPARγ agonist played the opposite role. In conclusion, air-ventilated NMP confers a better liver retrieval from DCD rats through the DAP-PPARγ-CYP2E1 axis; CYP2E1 activity provides a biomarker of liver retrieval from DCD.

scholarly journals Effects of Oxygen During Long-term Hypothermic Machine Perfusion in a Porcine Model of Kidney Donation After Circulatory Death

2019 ◽  
Vol 103 (10) ◽  
pp. 2057-2064 ◽  
Author(s):  
Leonie H. Venema ◽  
Aukje Brat ◽  
Cyril Moers ◽  
Nils A. ‘t Hart ◽  
Rutger J. Ploeg ◽  
...  
Keyword(s):  
Porcine Model ◽  
Kidney Donation ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Hypothermic Machine Perfusion ◽  
Circulatory Death

scholarly journals Sequential Use of Normothermic Regional and Ex Situ Machine Perfusion in Donation After Circulatory Death Liver Transplant

2020 ◽  
Author(s):  
Davide Ghinolfi ◽  
Daniele Dondossola ◽  
Erion Rreka ◽  
Caterina Lonati ◽  
Daniele Pezzati ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Ex Situ ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Circulatory Death
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