Machine perfusion organ preservation: Highlights from the American Transplant Congress 2021

2021 ◽  
Author(s):  
Juliana Pavan‐Guimaraes ◽  
Ali Zarrinpar ◽  
Thiago Beduschi ◽  
Carl Atkinson ◽  
Paulo N. Martins
Keyword(s):  
Organ Preservation ◽  
Machine Perfusion

scholarly journals A simple ex vivo model of human renal allograft preservation using the gonadal vein

2019 ◽  
Vol 101 (8) ◽  
pp. 609-616
Author(s):  
WP Ries ◽  
Y Marie ◽  
K Patel ◽  
C Turnbull ◽  
TB Smith ◽  
...  
Keyword(s):  
Cold Storage ◽  
Organ Preservation ◽  
Caspase 3 ◽  
Ex Vivo ◽  
Human Model ◽  
Machine Perfusion ◽  
Flow Conditions ◽  
Ex Vivo Perfusion ◽  
Gonadal Vein ◽  
Hypothermic Machine Perfusion

Introduction Hypothermic machine perfusion, an organ preservation modality, involves flow of chilled preservation fluid through an allograft’s vasculature. This study describes a simple, reproducible, human model that allows for interrogation of flow effects during ex vivo organ perfusion. Materials and methods Gonadal veins from deceased human renal allografts were subjected to either static cold storage or hypothermic machine perfusion for up to 24 hours. Caspase-3, Krüppel-like factor 2 expression and electron microscopic analysis were compared between ‘flow’ and ‘no-flow’ conditions, with living donor gonadal vein sections serving as negative controls. Results The increase in caspase-3 expression was less pronounced for hypothermic machine-perfused veins compared with static cold storage (median-fold increase 1.2 vs 2.3; P < 0.05). Transmission electron microscopy provided ultrastructural corroboration of endothelial cell apoptosis in static cold storage conditions. For static cold storage preserved veins, Krüppel-like factor 2 expression diminished in a time-dependent manner between baseline and 12 hours (P < 0.05) but was abrogated and reversed by hypothermic machine perfusion (P < 0.05). Conclusions Our methodology is a simple, reproducible and successful model of ex vivo perfusion in the context of human organ preservation. To demonstrate the model’s utility, we establish that two widely used markers of endothelial health (caspase-3 and Krüppel-like factor 2) differ between the flow and no-flow conditions of the two predominant kidney preservation modalities. These findings suggest that ex vivo perfusion may mediate the induction of a biochemically favourable endothelial niche which may contribute tohypothermic machine perfusion’s association with improved renal transplantation outcomes.

scholarly journals Application of Mesenchymal Stem Cells During Machine Perfusion: An Emerging Novel Strategy for Organ Preservation

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiale Li ◽  
Qinbao Peng ◽  
Ronghua Yang ◽  
Kunsheng Li ◽  
Peng Zhu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Organ Transplantation ◽  
Organ Preservation ◽  
Ischemia Reperfusion ◽  
Solid Organ Transplantation ◽  
Therapeutic Effects ◽  
Solid Organ ◽  
Machine Perfusion ◽  
Marginal Grafts

Although solid organ transplantation remains the definitive management for patients with end-stage organ failure, this ultimate treatment has been limited by the number of acceptable donor organs. Therefore, efforts have been made to expand the donor pool by utilizing marginal organs from donation after circulatory death or extended criteria donors. However, marginal organs are susceptible to ischemia-reperfusion injury (IRI) and entail higher requirements for organ preservation. Recently, machine perfusion has emerged as a novel preservation strategy for marginal grafts. This technique continually perfuses the organs to mimic the physiologic condition, allows the evaluation of pretransplant graft function, and more excitingly facilitates organ reconditioning during perfusion with pharmacological, gene, and stem cell therapy. As mesenchymal stem cells (MSCs) have anti-oxidative, immunomodulatory, and regenerative properties, mounting studies have demonstrated the therapeutic effects of MSCs on organ IRI and solid organ transplantation. Therefore, MSCs are promising candidates for organ reconditioning during machine perfusion. This review provides an overview of the application of MSCs combined with machine perfusion for lung, kidney, liver, and heart preservation and reconditioning. Promising preclinical results highlight the potential clinical translation of this innovative strategy to improve the quality of marginal grafts.

Review of Current Machine Perfusion Therapeutics for Organ Preservation

2020 ◽  
Vol 104 (9) ◽  
pp. 1792-1803 ◽  
Author(s):  
Jing Xu ◽  
Julianna E. Buchwald ◽  
Paulo N. Martins
Keyword(s):  
Organ Preservation ◽  
Machine Perfusion

scholarly journals Advances in machine perfusion, organ preservation, and cryobiology

2018 ◽  
pp. 1 ◽  
Author(s):  
Laura C. Burlage ◽  
Shannon N. Tessier ◽  
Joanna W. Etra ◽  
Korkut Uygun ◽  
Gerald Brandacher
Keyword(s):  
Organ Preservation ◽  
Machine Perfusion

14. Hypothermic machine perfusion for organ preservation

Cryobiology ◽  
2006 ◽  
Vol 53 (3) ◽  
pp. 372-373 ◽  
Author(s):  
Thomas M. van Gulik ◽  
Maud Bessems ◽  
Marie-Claire Schreinemachers ◽  
Arelene K. van Vliet ◽  
Benedict M. Doorschodt
Keyword(s):  
Organ Preservation ◽  
Machine Perfusion ◽  
Hypothermic Machine Perfusion

Organ Preservation in Liver Transplantation

2018 ◽  
Vol 38 (03) ◽  
pp. 260-269 ◽  
Author(s):  
Alberto Zanetto ◽  
Francesco Russo ◽  
Giacomo Germani ◽  
Patrizia Burra
Keyword(s):  
Liver Transplantation ◽  
Cold Storage ◽  
Organ Preservation ◽  
Clinical Applications ◽  
Ex Situ ◽  
Machine Perfusion ◽  
Donor Pool ◽  
Number Of Patients ◽  
Pros And Cons ◽  
Donor Shortage

AbstractThe discrepancy between the number of patients awaiting liver transplantation and the number of available donors has become a key issue in the transplant setting. Various strategies to cope with the donor shortage problem and to increase the use of suboptimal grafts have been explored. Machine perfusion has been applied ex situ to liver grafts in the effort to improve static cold-storage preservation. If a more extensive application of this technology confirms the preliminary results, machine perfusion will become crucial in increasing the donor pool as well as improving recipients' outcomes. In this review, the authors focused on the evolution of machine perfusion, from the first animal experiences to the latest evidence in humans, highlighting the pros and cons as well as the potential clinical applications of various types of machine.

scholarly journals Combination of mesenchymal stromal cells and machine perfusion is a novel strategy for organ preservation in solid organ transplantation

2021 ◽  
Author(s):  
Lingfei Zhao ◽  
Chenxia Hu ◽  
Fei Han ◽  
Dajin Chen ◽  
Yanhong Ma ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Organ Preservation ◽  
Ex Vivo ◽  
Solid Organ Transplantation ◽  
Organ Shortage ◽  
Solid Organ ◽  
Machine Perfusion ◽  
Organ Function

AbstractOrgan preservation is a prerequisite for an urgent increase in the availability of organs for solid organ transplantation (SOT). An increasing amount of expanded criteria donor (ECD) organs are used clinically. Currently, the paradigm of organ preservation is shifting from simple reduction of cellular metabolic activity to maximal simulation of an ex vivo physiological microenvironment. An ideal organ preservation technique should not only preserve isolated organs but also offer the possibility of rehabilitation and evaluation of organ function prior to transplantation. Based on the fact that mesenchymal stromal cells (MSCs) possess strong regeneration properties, the combination of MSCs with machine perfusion (MP) is expected to be superior to conventional preservation methods. In recent years, several studies have attempted to use this strategy for SOT showing promising outcomes. With better organ function during ex vivo preservation and the potential of utilization of organs previously deemed untransplantable, this strategy is meaningful for patients with organ failure to help overcome organ shortage in the field of SOT.

Sign in / Sign up

Export Citation Format

Share Document