Back to Search
Start Over
Influence of different partial pressures of oxygen during continuous hypothermic machine perfusion in a pig kidney ischemia-reperfusion autotransplant model
- Source :
- Transplantation, (2019)
- Publication Year :
- 2019
- Publisher :
- Hagerstown, MD : Lippincott Williams & Wilkins, 2019.
-
Abstract
- Background The optimal perfusate partial pressure of oxygen (PO2) during hypothermic machine perfusion (HMP) is unknown. The aims of the study were to determine the functional, metabolic, structural, and flow dynamic effects of low and high perfusate PO2 during continuous HMP in a pig kidney ischemia-reperfusion autotransplant model. Methods The left kidneys of a ±40 kg pigs were exposed to 30 minutes of warm ischemia and randomized to receive 22-hour HMP with either low perfusate PO2 (30% oxygen, low oxygenated HMP [HMPO2]) (n = 8) or high perfusate PO2 (90% oxygen, HMPO2high) (n = 8), before autotransplantation. Kidneys stored in 22-hour standard HMP (n = 6) and 22-hour static cold storage (n = 6) conditions served as controls. The follow-up after autotransplantation was 13 days. Results High PO2 resulted in a 3- and 10-fold increase in perfusate PO2 compared with low HMPO2 and standard HMP, respectively. Both HMPO2 groups were associated with superior graft recovery compared with the control groups. Oxygenation was associated with a more rapid and sustained decrease in renal resistance. While there was no difference in functional outcomes between both HMPO2 groups, there were clear metabolic differences with an inverse correlation between oxygen provision and the concentration of major central metabolites in the perfusion fluid but no differences were observed by oxidative stress and metabolic evaluation on preimplantation biopsies. Conclusions While this animal study does not demonstrate any advantages for early graft function for high perfusate PO2, compared with low perfusate PO2, perfusate metabolic profile analysis suggests that aerobic mechanism is better supported under high perfusate PO2 conditions.
- Subjects :
- medicine.medical_specialty
Time Factors
animal structures
Partial Pressure
Sus scrofa
Ischemia
Cold storage
030230 surgery
Kidney
Transplantation, Autologous
03 medical and health sciences
Random Allocation
0302 clinical medicine
Hypothermia, Induced
Internal medicine
medicine
Animals
Kidney surgery
Warm Ischemia
Transplantation
Machine perfusion
Chemistry
Cold Ischemia
Kidney metabolism
Oxygenation
Equipment Design
Hypothermia
medicine.disease
Kidney Transplantation
Oxygen
Perfusion
Creatinine
Models, Animal
Cardiology
030211 gastroenterology & hepatology
Female
medicine.symptom
Energy Metabolism
Biomarkers
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Transplantation, (2019)
- Accession number :
- edsair.doi.dedup.....688f1ebfe40a57c4b9240b3db966ec80