Analysis of machine perfusion benefits in kidney grafts: a preclinical study

Journal of Translational Medicine

Research

Serge Milin¹  Raphaël Thuillier²  Frederic D Favreau²  Thierry Hauet³  Michel Eugene⁴  Nicolas P Chatauret⁴  Benoit Barrou⁵  Nader Vaziri⁶ 

[1] Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;CHU Poitiers, Pole UBM, Service de Biochimie, F-86021, Poitiers, France;FLIRT : Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, F-86034, Poitiers, France;Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;CHU Poitiers, Pole UBM, Service de Biochimie, F-86021, Poitiers, France;IBISA, Domaine expérimental du Magneraud, F17700, Surgères, France;FLIRT : Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, F-86034, Poitiers, France;Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;IBISA, Domaine expérimental du Magneraud, F17700, Surgères, France;FLIRT : Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, F-86034, Poitiers, France;Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;IBISA, Domaine expérimental du Magneraud, F17700, Surgères, France;Service d'Urologie et Transplantation, Hôpital Pitié Salpétrière, Groupe Hospitalier Universitaire Est, Paris cedex 13, 75651, Paris, France;Université Pierre et Marie Curie, Paris cedex, 75005, Paris, France;FLIRT : Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, F-86034, Poitiers, France;Inserm U927, Poitiers, Poitiers F-86021, France, Univ Poitiers; Faculté de Médecine et de Pharmacie, F-86034, Poitiers, France;Service d'Urologie et chirurgie de la transplantation, Pavillon V - Hôpital Edouard Herriot - 5, place d'Arsonval, 69437, Lyon, France;

关键词: Cold Storage;    Delay Graft Function;    Kidney Graft;    Preservation Solution;    Machine Perfusion;   

DOI  :  10.1186/1479-5876-9-15

 received in 2010-09-28, accepted in 2011-01-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMachine perfusion (MP) has potential benefits for marginal organs such as from deceased from cardiac death donors (DCD). However, there is still no consensus on MP benefits. We aimed to determine machine perfusion benefits on kidney grafts.MethodsWe evaluated kidney grafts preserved in ViaspanUW or KPS solutions either by CS or MP, in a DCD pig model (60 min warm ischemia + 24 h hypothermic preservation). Endpoints were: function recovery, quality of function during follow up (3 month), inflammation, fibrosis, animal survival.ResultsViaspanUW-CS animals did not recover function, while in other groups early follow up showed similar values for kidney function. Alanine peptidase and β-NAG activities in the urine were higher in CS than in MP groups. Oxydative stress was lower in KPS-MP animals. Histology was improved by MP over CS. Survival was 0% in ViaspanUW-CS and 60% in other groups. Chronic inflammation, epithelial-to-mesenchymal transition and fibrosis were lowest in KPS-MP, followed by KPS-CS and ViaspanUW-MP.ConclusionsWith ViaspanUW, effects of MP are obvious as only MP kidney recovered function and allowed survival. With KPS, the benefits of MP over CS are not directly obvious in the early follow up period and only histological analysis, urinary tubular enzymes and red/ox status was discriminating. Chronic follow-up was more conclusive, with a clear superiority of MP over CS, independently of the solution used. KPS was proven superior to ViaspanUW in each preservation method in terms of function and outcome. In our pre-clinical animal model of DCD transplantation, MP offers critical benefits.

【 授权许可】

Unknown   
© Vaziri et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.