606 Beneficial effect of a short-period of hypothermic pulsatile machine perfusion of warm ischemic kidneys just before the transplant. Experimental study

Humanes-Sanchez, B.; Lazaro-Fernandez, A.; Jado, Juan Carlos; Mojena-Sánchez, M.; Ramírez-Martín, D.; Agra, Carmen Ornosa; Álvarez, Enric; Canizo-Lopez, J.F. Del; Hernández-Fernández, C.; Tejedor-Jorge, A.; Lledó-García, E.

doi:10.1016/s1569-9056(13)61089-1

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“…Subsequent clinical application of HMP after cold storage produced the first clinical evidence of a beneficial effect of the technique [ 17 ]. Our group had already reported preliminary results on the theoretical advantages of HMP over cold storage, concluding that short periods of HMP after cold ischemia for warm-ischemic kidneys immediately before the transplant would be beneficial [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, waveform is important for reduction of the shear-stress effect on the endothelium associated with perfusion. Our group previously reported the beneficial consequences of a pulsatile waveform generated by a vacuum pump, which was associated mainly with more marked release of nitric oxide during the perfusion process and probably during the initial rewarming period [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Beneficial Effect of Short Pretransplant Period of Hypothermic Pulsatile Perfusion of the Warm-Ischemic Kidney after Cold Storage: Experimental Study

Lázaro

Humanes

Jado

et al. 2016

BioMed Research International

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Warm ischemia (WI) produces a significant deleterious effect in potential kidney grafts. Hypothermic machine perfusion (HMP) seems to improve immediate graft function after transplant. Our aim was to analyze the effect of short pretransplant periods of pulsatile HMP on histology and renal injury in warm-ischemic kidneys. Twelve minipigs were used. WI was achieved in the right kidney by applying a vascular clamp for 45 min. After nephrectomy, autotransplant was performed following one of two strategies: cold storage of the kidneys or cold storage combined with perfusion in pulsatile HMP. The graft was removed early to study renal morphology, inflammation (fibrosis), and apoptosis. Proinflammatory activity and fibrosis were less pronounced after cold storage of the kidneys with HMP than after cold storage only. The use of HMP also decreased apoptosis compared with cold storage only. The detrimental effects on cells of an initial and prolonged period of WI seem to improve with a preservation protocol that includes a short period of pulsatile HMP after cold storage and immediately before the transplant, in comparison with cold storage only.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%