Improving the quality of kidneys from non-heart-beating donors, using streptokinase: An animal model1

Abstract

The use of streptokinase in this porcine NHBD model conferred benefits to donor kidneys when assessed by machine perfusion. Markers of biochemical injury indicated that less renal tissue damage occurred with the incorporation of streptokinase in the in situ flush medium.

Fibrinolytic Treatment Improves the Quality of Lungs Retrieved From Non-Heart-Beating Donors

“…[17][18][19][20][21][22][23][24][25] In a canine left lung allotransplantation model using NHBDs, the injection of high-dose urokinase into the main pulmonary artery after flush significantly resulted in a better graft function compared with control animals after 2 hours of warm ischemia. 17 In a similar model, recombinant tissue-type plasminogen activator improved lung function at a dose of 5 g/kg/min compared with 2.5 g/kg/min; however, the probability of hemorrhagic complications was assumed to be higher.…”

“…22 The use of streptokinase in the in situ flush solution in a porcine model improved pre-transplant kidney preservation from NHBDs in a machine perfusion system. 25 In a double-blinded, randomized, controlled trial a higher proportion of kidneys were transplanted from NHBDs through the use of streptokinase. No difference was found with respect to postoperative bleeding and transfusion requirements in the recipient between the 2 groups.…”

Supercooling enables long-term transplantation survival following 4 days of liver preservation

“…Finally, to counter the effects of extended ischemia we employed machine perfusion, which has been demonstrated to alleviate hypothermic endothelial injury 28 , reinitialize metabolic activity, replenish ATP, and mechanically prime the vasculature for reperfusion 19,35–37 . We chose subnormothermic machine perfusion (SNMP) based on our success in using this method for recovering 1 h warm ischemic rat livers for transplantation 38–40 .…”

Current status and recent advances of liver transplantation from donation after cardiac death

“…The initial reports of pre-flush with streptokinase were centered on renal transplantation demonstrating the improved microvascular permeability and graft function [67,68] . The convincing results led to routine incorporation of this to the practice among many centers [69] .…”