Machine Perfusion for Kidneys With Multiple Arteries: An Unusual Reconstruction With an Iliac Arterial Graft

2021 ◽  
Vol 19 (8) ◽  
pp. 884-885
Author(s):  
Riccardo De Carlis ◽  
Iacopo Mangoni ◽  
Andrea Lauterio ◽  
Niccolò Incarbone ◽  
Luciano De Carlis
Keyword(s):  
Arterial Graft ◽  
Machine Perfusion

G4120, an Arg-Gly-Asp Containing Pentapeptide, Enhances Arterial Eversion Graft Recanalization with Recombinant Tissue-Type Plasminogen Activator in Dogs

1992 ◽  
Vol 67 (06) ◽  
pp. 686-691 ◽  
Author(s):  
Hua Rong Lu ◽  
Herman K Gold ◽  
Zaomin Wu ◽  
Tsunehiro Yasuda ◽  
Patrick Pauwels ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Arterial Occlusion ◽  
Tissue Type ◽  
Clot Lysis ◽  
Arterial Graft ◽  
Tissue Type Plasminogen Activator ◽  
Group I ◽  
Type Plasminogen Activator ◽  
Platelet Receptor ◽  
Observation Period

SummaryThe effects of G4120, a cyclic Arg-Gly-Asp (RGD) containing peptide which inhibits fibrinogen binding to the platelet receptor GPIIb/IIIa, on thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) were investigated in a combined arterial and venous thrombosis model in heparinized dogs. The arterial thrombus model consisted of a 3 cm everted (inside-out) carotid arterial segment inserted into a transsected femoral artery which occludes within 30 min with platelet-rich material and which is resistant to recanalization with 0.5 mg/kg rt-PA. The venous thrombus was a 125I-fibrin labeled whole blood clot produced in the contralateral femoral vein.In 5 dogs given an intravenous bolus of 0.05 mg/kg G4120 followed by a continuous infusion of 0.05 mg/kg per hour for 3 h (group I), arterial occlusion persisted throughout a 4 h observation period and was still present at 24 h in all dogs; the extent of venous clot lysis after 120 min was 27 ± 7%. In 5 dogs given the same infusion of G4120 in combination with 0.5 mg/kg rt-PA over 60 min, recanalization of the arterial graft occurred in all dogs, within 13 ± 2 min and persisted throughout the observation period of 4 h (p = 0.01 versus G4120 or rt-PA alone); at 24 h, however, all grafts were occluded. Venous clot lysis in this group was 75 ± 8% (p = 0.002 versus G4120 alone andp NS versus rt-PA alone). Pathologic analysis revealed platelet-rich or mixed thrombus with platelet-rich and erythrocyte-rich zones. The last 6 dogs were given a reduced dose of G4120 consisting either of a 0.05 mg/kg bolus followed by an infusion of 0.05 mg/kg over 1 h in 3 dogs (group III) or of a single 0.05 mg/kg bolus in 3 dogs (group IV), both given in combination with 0.5 mg/kg rt-PA infused over 60 min. These protocols produced recanalization within 15 ± 2 and 34 ± 8 min, respectively, which was maintained throughout the 4 h observation period. Venous lysis in these groups was 63 ± 4 and 97 ± 1% respectively. Bleeding times prolonged from 1 to 2 min to >30 min with G4120, but returned towards baseline within 2 h after the end of the infusion. Platelet aggregation with ADP was completely inhibited with G4120 but partially recovered within 1 h after the end of the infusion. No fibrinogen breakdown was observed in association with the rt-PA infusion.Thus, G4120, a synthetic GPIIb/IIIa receptor antagonist, enhances and accelerates lysis of platelet-rich arterial thrombosis with rt-PA and prevents reocclusion during and within 3 h after the infusion. It may be useful for the conjunctive use with thrombolytic agents in patients with arterial thromboembolic disease.

Optimization of a new preservation solution for machine perfusion of the liver: Which is the preferred colloid?

2005 ◽  
Vol 37 (1) ◽  
pp. 329-331 ◽  
Author(s):  
M. Bessems ◽  
B.M. Doorschodt ◽  
O. Hooijschuur ◽  
A.K. van Vliet ◽  
T.M. van Gulik
Keyword(s):  
Machine Perfusion ◽  
Preservation Solution

scholarly journals Optimizing porcine donor kidney preservation with normothermic or hypothermic machine perfusion: A systematic review

2021 ◽  
Author(s):  
Sarah Bouari ◽  
Özgür Eryigit ◽  
Ron W. F. Bruin ◽  
Jan N. M. IJzermans ◽  
Robert C. Minnee
Keyword(s):  
Systematic Review ◽  
Machine Perfusion ◽  
Donor Kidney ◽  
Kidney Preservation ◽  
Hypothermic Machine Perfusion

scholarly journals Mitochondrial Reprogramming—What Is the Benefit of Hypothermic Oxygenated Perfusion in Liver Transplantation?

2021 ◽  
Vol 2 (2) ◽  
pp. 149-161
Author(s):  
Rebecca Panconesi ◽  
Mauricio Flores Carvalho ◽  
Matteo Mueller ◽  
Philipp Dutkowski ◽  
Paolo Muiesan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Clinical Trials ◽  
Randomized Controlled Trial ◽  
Cohort Studies ◽  
Controlled Trial ◽  
Machine Perfusion ◽  
Randomized Controlled ◽  
Hypothermic Perfusion ◽  
Underlying Mechanisms ◽  
Circulatory Death

Although machine perfusion is a hot topic today, we are just at the beginning of understanding the underlying mechanisms of protection. Recently, the first randomized controlled trial reported a significant reduction of ischemic cholangiopathies after transplantation of livers donated after circulatory death, provided the grafts were treated with an endischemic hypothermic oxygenated perfusion (HOPE). This approach has been known for more than fifty years, and was initially mainly used to preserve kidneys before implantation. Today there is an increasing interest in this and other dynamic preservation technologies and various centers have tested different approaches in clinical trials and cohort studies. Based on this, there is a need for uniform perfusion settings (perfusion route and duration), and the development of general guidelines regarding the duration of cold storage in context of the overall donor risk is also required to better compare various trial results. This article will highlight how cold perfusion protects organs mechanistically, and target such technical challenges with the perfusion setting. Finally, the options for viability testing during hypothermic perfusion will be discussed.

scholarly journals Zebrafish as a New Tool in Heart Preservation Research

2021 ◽  
Vol 8 (4) ◽  
pp. 39
Author(s):  
Luciana Da Silveira Cavalcante ◽  
Shannon N. Tessier
Keyword(s):  
New Technologies ◽  
Ex Vivo ◽  
Machine Perfusion ◽  
Life Saving ◽  
First Choice ◽  
Heart Preservation ◽  
End Stage Heart Failure ◽  
Ischemia Tolerance ◽  
The 1960S ◽  
End Stage

Heart transplantation became a reality at the end of the 1960s as a life-saving option for patients with end-stage heart failure. Static cold storage (SCS) at 4–6 °C has remained the standard for heart preservation for decades. However, SCS only allows for short-term storage that precludes optimal matching programs, requires emergency surgeries, and results in the unnecessary discard of organs. Among the alternatives seeking to extend ex vivo lifespan and mitigate the shortage of organs are sub-zero or machine perfusion modalities. Sub-zero approaches aim to prolong cold ischemia tolerance by deepening metabolic stasis, while machine perfusion aims to support metabolism through the continuous delivery of oxygen and nutrients. Each of these approaches hold promise; however, complex barriers must be overcome before their potential can be fully realized. We suggest that one barrier facing all experimental efforts to extend ex vivo lifespan are limited research tools. Mammalian models are usually the first choice due to translational aspects, yet experimentation can be restricted by expertise, time, and resources. Instead, there are instances when smaller vertebrate models, like the zebrafish, could fill critical experimental gaps in the field. Taken together, this review provides a summary of the current gold standard for heart preservation as well as new technologies in ex vivo lifespan extension. Furthermore, we describe how existing tools in zebrafish research, including isolated organ, cell specific and functional assays, as well as molecular tools, could complement and elevate heart preservation research.

PRESERVATION OF CADAVER RENAL ALLOGRAFTS: COMPARISON OF ICE STORAGE AND MACHINE PERFUSION

1977 ◽  
Vol 2 (11) ◽  
pp. 353-356 ◽  
Author(s):  
V. C. Marshall ◽  
H. Ross ◽  
D. F. Scott ◽  
S. McInnes ◽  
N. Thomson ◽  
...  
Keyword(s):  
Ice Storage ◽  
Machine Perfusion ◽  
Renal Allografts

scholarly journals Hypothermic oxygenated Machine Perfusion of the Human Pancreas for Clinical Islet Isolation: A Prospective Feasibility Study

2021 ◽  
Author(s):  
Jason B. Doppenberg ◽  
Marjolein Leemkuil ◽  
Marten A. Engelse ◽  
Christina Krikke ◽  
Eelco J.P. de Koning ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Human Pancreas ◽  
Islet Isolation ◽  
Machine Perfusion

scholarly journals Human liver stem cell‐derived extracellular vesicles reduce injury in a model of normothermic machine perfusion of rat livers previously exposed to a prolonged warm ischemia

2021 ◽  
Vol 34 (9) ◽  
pp. 1607-1617
Author(s):  
Nicola De Stefano ◽  
Victor Navarro‐Tableros ◽  
Dorotea Roggio ◽  
Alberto Calleri ◽  
Federica Rigo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Extracellular Vesicles ◽  
Human Liver ◽  
Warm Ischemia ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion ◽  
Rat Livers
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