Comparison of Extracellular-Type–Kyoto Solution and Perfadex as a Preservation Solution in a Pig Ex Vivo Lung Perfusion Model: Impact of Potassium Level

Okamoto, Toshihiro; Chen, F.; Zhang, J.; Choi, HS; Yamada, Tetsu; Morikawa, Hiromasa; Nakayama, Eiichiro; Bando, Toru; Date, Hiroshi

doi:10.1016/j.transproceed.2011.03.012

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Other groups have successfully conducted perfusion experiments with slaughterhouse organs including kidneys, 14,49 livers, 50,51 hearts, 15,52 and lungs. 12,13,53 …”

Section: Discussionmentioning

confidence: 99%

Comparison of normothermic and hypothermic perfusion in porcine kidneys donated after cardiac death

Blum

Liu

Soliman

et al. 2017

Journal of Surgical Research

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Background Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. Methods Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia. After 8 hours of machine preservation, hemodynamic stability, renal function, perfusate biomarkers, and histologic integrity were assessed in a simulated reperfusion model. Results Upon simulated reperfusion, no differences were observed in oxygen consumption, urine production, creatinine clearance, fractional excretion of sodium, proteinuria, and perfusate levels of lactate dehydrogenase and aspartate aminotransferase. Resistance was no different after 30 minutes of simulated reperfusion. NMP kidneys demonstrated increased histologic vacuolization after preservation and greater loss of tubular integrity after simulated reperfusion. Perfusate levels of alkaline phosphatase (AP) and gamma glutamyltransferase (GGT) were higher in NMP kidneys during preservation, but upon simulated reperfusion, AP and GGT levels were higher in HMP-preserved kidneys. Peak AP and GGT during HMP simulated reperfusion were over 14 times higher than peak AP and GGT during NMP preservation. Conclusions NMP provided comparable preservation of renal function as HMP and minimized AP and GGT release upon reperfusion.

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“…Other groups have successfully conducted perfusion experiments with slaughterhouse organs including kidneys, 14,49 livers, 50,51 hearts, 15,52 and lungs. 12,13,53 …”

Section: Discussionmentioning

confidence: 99%

Comparison of normothermic and hypothermic perfusion in porcine kidneys donated after cardiac death

Blum

Liu

Soliman

et al. 2017

Journal of Surgical Research

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show abstract

“…Avsar et al (13) concluded in a pig model that lung architecture and oxygenation were satisfactory using hyperoncotic nonalbumin solution. Comparisons of Perfadex with other perfusates, such as the Kyoto perfusates (14), showed no difference in pulmonary vascular resistance (PVR) and oxygenation. Initially, Steen et al (9) as well as others (15,16) popularized cellular perfusion for EVLP.…”

Section: Perfusate and Preservative Compositionmentioning

confidence: 99%

“…The routine change of perfusate remains debatable. There are data suggesting that the removal of a quantity of the perfusate may avoid hyperkalemia (14).…”

Section: Perfusate and Preservative Compositionmentioning

confidence: 99%

Ex Vivo Lung Perfusion

Roman

Nair²,

Tsui³

et al. 2013

Transplantation

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There is a critical mismatch between the number of donor lungs available and the demand for lungs for transplantation. This has created unacceptably high waiting-list mortality for lung transplant recipients. Currently (2012) in the United Kingdom, there are 216 patients on the lung transplant waiting list and 17 on heart and lung transplant list. The waiting times for suitable lungs average 412 days, with an increasing mortality and morbidity among the patients on the lung transplant list. Ex vivo lung perfusion (EVLP) has emerged as a technique for the assessment, resuscitation, and potential repair of suboptimal donor lungs. This is a rapidly developing field with significant clinical implications. In this review article, we critically appraise the background developments that have led to our current clinical practice. In particular, we focus on the human and animal experience, the different perfusion-ventilation strategies, and the impact of different perfusates and leukocyte filters. Finally, we examine EVLP as a potential research tool. This will provide insight into EVLP and its future development in the field of clinical lung transplantation.

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Prediction of transplant outcome after 24-hour ex vivo lung perfusion using the Organ Care System in a porcine lung transplantation model

Sommer

Salman

Avşar

et al. 2019

American Journal of Transplantation

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Ex vivo lung perfusion (EVLP) has become routine practice in lung transplantation. Still, running periods exceeding 12 hours have not been undertaken clinically to date, and it remains unclear how the perfusion solution for extended running periods should be composed and which parameters may predict outcomes. Twenty-four porcine lungs underwent EVLP for 24 hours using the Organ Care System (OCS). Lungs were ventilated and perfused with STEEN's solution enriched with erythrocytes (n = 8), acellular STEEN's solution (n = 8), or low-potassium dextran (LPD) solution enriched with erythrocytes (n = 8). After 24 hours, the left lungs were transplanted into recipient pigs. After clamping of the contralateral lung, the recipients were observed for 6 hours. The most favorable outcome was observed in organs utilizing STEEN solution enriched with erythrocytes as perfusate, whereas the least favorable outcome was seen with LPD solution enriched with erythrocytes for perfusion. Animals surviving the observation period showed lower peak airway pressure (PAWP) and pulmonary vascular resistance (PVR) during OCS preservation. The results suggest that transplantation of lungs following 24 hours of EVLP is feasible but dependent on the composition of the perfusate. PAWP and PVR during EVLP are early and late predictors of transplant outcome, respectively.

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Comparison of Extracellular-Type–Kyoto Solution and Perfadex as a Preservation Solution in a Pig Ex Vivo Lung Perfusion Model: Impact of Potassium Level

Abstract: The pig EVLP system was not affected when ET-K was used instead of PX as the flush/preservation solution. The initial 200 mL of effluent should be discarded when using the ET-K to ensure that the potassium level does not increase.

Cited by 3 publications

References 10 publications

Comparison of normothermic and hypothermic perfusion in porcine kidneys donated after cardiac death

Comparison of normothermic and hypothermic perfusion in porcine kidneys donated after cardiac death

Ex Vivo Lung Perfusion

Prediction of transplant outcome after 24-hour ex vivo lung perfusion using the Organ Care System in a porcine lung transplantation model

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