scholarly journals Hypothermic oxygenated machine perfusion for extended criteria donor allografts – preliminary experience with extended organ preservation times in the setting of organ reallocation

2021 ◽  
Author(s):  
Sandra Pavicevic ◽  
Deniz Uluk ◽  
Sophie Reichelt ◽  
Panagiotis Fikatas ◽  
Brigitta Globke ◽  
...  
Keyword(s):  
Organ Preservation ◽  
Machine Perfusion ◽  
Extended Criteria Donor

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

Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers

2016 ◽  
Vol 100 (4) ◽  
pp. 825-835 ◽  
Author(s):  
Andrie C. Westerkamp ◽  
Negin Karimian ◽  
Alix P. M. Matton ◽  
Paria Mahboub ◽  
Rianne van Rijn ◽  
...  
Keyword(s):  
Cold Storage ◽  
Machine Perfusion ◽  
Extended Criteria Donor ◽  
Hypothermic Machine Perfusion

scholarly journals Oxygenated hypothermic machine perfusion after static cold storage improves endothelial function of extended criteria donor livers

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e4
Author(s):  
L.C. Burlage ◽  
N. Karimian ◽  
A.C. Westerkamp ◽  
N. Visser ◽  
S. Op den Dries ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Cold Storage ◽  
Machine Perfusion ◽  
Extended Criteria Donor ◽  
Hypothermic Machine Perfusion

scholarly journals Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

2020 ◽  
Vol 11 ◽  
Author(s):  
Mindaugas Kvietkauskas ◽  
Bettina Leber ◽  
Kestutis Strupas ◽  
Philipp Stiegler ◽  
Peter Schemmer
Keyword(s):  
Machine Perfusion ◽  
Extended Criteria Donor ◽  
Donor Organs

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.

scholarly journals Hypothermic Oxygenated Machine Perfusion of Extended Criteria Kidney Allografts from Brain Dead Donors: Protocol for a Prospective Pilot Study

10.2196/14622 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14622 ◽  
Author(s):  
Franziska Alexandra Meister ◽  
Zoltan Czigany ◽  
Jan Bednarsch ◽  
Jörg Böcker ◽  
Iakovos Amygdalos ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Pilot Study ◽  
Brain Death ◽  
Ischemia Reperfusion ◽  
Kidney Tissue ◽  
Organ Shortage ◽  
Machine Perfusion ◽  
Extended Criteria Donor ◽  
Prospective Pilot Study ◽  
Clinical Series

Background Kidney transplantation is the only curative treatment option for end-stage renal disease. The unavailability of adequate organs for transplantation has resulted in a substantial organ shortage. As such, kidney donor allografts that would have previously been deemed unsuitable for transplantation have become an essential organ pool of extended criteria donor allografts that are now routinely being transplanted on a global scale. However, these extended criteria donor allografts are associated with significant graft-related complications. As a result, hypothermic oxygenated machine perfusion (HOPE) has emerged as a powerful, novel technique in organ preservation, and it has recently been tested in preclinical trials in kidney transplantation. In addition, HOPE has already provided promising results in a few clinical series of liver transplantations where the liver was donated after cardiac death. Objective The present trial is an investigator-initiated prospective pilot study on the effects of HOPE on extended criteria donor allografts donated after brain death and used in kidney transplantation. Methods A total of 15 kidney allografts with defined inclusion/exclusion criteria will be submitted to two hours of HOPE via the renal artery before implantation, and are going to be compared to a case-matched group of 30 patients (1:2 matching) who had kidneys transplanted after conventional cold storage. Primary (posttransplant dialysis within 7 days) and secondary (postoperative complications, early graft function, duration of hospital and intensive care unit stay, and six-month graft survival) endpoints will be analyzed within a six-month follow-up period. The extent of ischemia-reperfusion injury will be assessed using kidney tissue, perfusate, and serum samples taken during the perioperative phase of kidney transplantation Results The results of this trial are expected in the first quarter of 2020 and will be presented at national and international scientific meetings and published in international peer-reviewed medical journals. The trial was funded in the third quarter of 2017 and patient enrollment is currently ongoing. Conclusions This prospective study is designed to explore the effects of HOPE on extended criteria donor kidney allografts donated after brain death. The present report represents the preresults phase. Trial Registration Clinicaltrials.gov NCT03378817; https://clinicaltrials.gov/ct2/show/NCT03378817

scholarly journals Transplantation of Extended Criteria Donor Livers Following Continuous Normothermic Machine Perfusion without Recooling

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zhitao Chen ◽  
Tielong Wang ◽  
Chuanbao Chen ◽  
Qiang Zhao ◽  
Yihao Ma ◽  
...  
Keyword(s):  
Machine Perfusion ◽  
Extended Criteria Donor ◽  
Normothermic Machine Perfusion
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