Normalization of nitric oxide flux improves physiological parameters of porcine kidneys maintained on pulsatile perfusion

Gage, Fred; Vodovotz, Yoram

doi:10.1016/j.niox.2003.10.001

Cited by 9 publications

(7 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nitric oxide release is responsible for vasodilatation and protects from hypertension in humans. There is a hypothesis that in machine perfusion nitric oxide seems to acts similar . Our observation fuels the hypothesis that nitric oxide release rather than the applied hydrostatic pressure is responsible for vasodilatation by machine preservation .…”

Section: Discussionsupporting

confidence: 82%

“…There is a hypothesis that in machine perfusion nitric oxide seems to acts similar . Our observation fuels the hypothesis that nitric oxide release rather than the applied hydrostatic pressure is responsible for vasodilatation by machine preservation . Based on the hypothesis of nitric oxide release being the basic mechanism behind vasodilatation of the renal microvasculature during perfusion, we hypothesize that lower nitric oxide release might possibly offer a plausible explanation for the higher renal resistances observed on the flow‐driven device, but this needs further investigation.…”

Section: Discussionsupporting

confidence: 70%

See 1 more Smart Citation

One-year results of a prospective, randomized trial comparing two machine perfusion devices used for kidney preservation

et al. 2013

View full text Add to dashboard Cite

SummaryStudies have shown beneficial effects of machine perfusion (MP) on early kidney function and long-term graft survival. The aim of this study was to investigate whether the type of perfusion device could affect outcome of transplantation of deceased donor kidneys. A total of 50 kidneys retrieved from 25 donors were randomized to machine perfusion using a flow-driven (FD) device (RM3; Waters Medical Inc) or a pressure-driven (PD) device (LifePort; Organ Recovery Systems), 24 of these kidneys (n = 12 pairs; 48%) were procured from expanded criteria donors (ECD). The primary endpoints were kidney function after transplantation defined using the incidence of delayed graft function (DGF), the number of hemodialysis sessions required, graft function at 12 months, and analyses of biopsy. DGF was similar in both groups (32%; 8/25). Patients with DGF in the FD group required a mean of 4.66 hemodialysis sessions versus 2.65 in the PD group (P = 0.005). Overall, 1-year graft survival was 80% (20/25) vs. 96% (24/25) in the FD and PD groups. One-year graft survival of ECD kidneys was 66% (8/12) in the FD group versus 92% (11/12) in the PD group. Interstitial fibrosis and tubular atrophy were significantly more common in the FD group -45% (5/11) vs. 0% (0/9) (P = 0.03) in PD group. There were no differences in creatinine levels between the groups. Machine perfusion using a pressure-driven device generating lower pulse stress is superior to a flow-driven device with higher pulse stress for preserving kidney function.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 70%

One-year results of a prospective, randomized trial comparing two machine perfusion devices used for kidney preservation

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In general, PP of kidneys is considered to function through stabilization of the organ by supplying nutrients and oxygen during storage, by decreasing intrarenal vasospasm and by removal of waste materials while mimicking circulation and increasing vascular compliance. Numerous diagnostic procedures and perfusate modifications have been introduced for PP throughout its evolution (21)(22)(23)(24)(25). Despite the abundance of literature examining these issues and novel technical methodologies, opinions regarding the ultimate efficacy of PP are mixed.…”

Section: Introductionmentioning

confidence: 99%

Are We Frozen in Time? Analysis of the Utilization and Efficacy of Pulsatile Perfusion in Renal Transplantation

Schold

Kaplan

Howard

et al. 2005

American Journal of Transplantation

146

View full text Add to dashboard Cite

Preservation techniques are crucial to deceased donor kidney transplantation (DDTx), but the efficacy of pulsatile perfusion (PP) versus cold storage (CS) remains uncertain. We describe patterns of PP use and explore four fundamental questions. What kidneys are selected for PP? How does PP affect utilization of donated kidneys? What effect does PP have on outcomes? When does PP appear to be most efficacious? We examined rates of PP in DDTx in the United States from 1994 to 2003. We generated models for organ utilization, delayed graft function (DGF) and for the use of PP. We analyzed the long-term effect of PP with multivariate Cox models. The utilization rates for nonexpanded criteria donors (ECDs) were similar by storage type, but for ECDs there was a significantly higher utilization rate with PP (70% with PP vs. 59% with CS, p < 0.001). Use of PP was widely variable across transplant centers. DGF rates were significantly lower with PP (27.6% vs. 19.6%). PP was associated with a mild benefit on death censored graft survival (adjusted hazard ratio = 0.88, 95% CI 0.85-0.91). Reduced DGF and significantly lower discard rates of ECDs associated with PP suggest an important utility of PP in renal transplantation. Additional evidence of improvement in graft survival, particularly in more recent years, provides further encouraging evidence for the use of PP.

show abstract

“…Experimental models addressing how to deliver cytoprotective mixtures, immune modulators or even immunosuppressive agents during HMP so as to prevent or reduce ischemia-reperfusion injury and rejection are under development [38][39][40]. In the future, stem cells treatment [41] and targeted gene therapy [42] toward donor organs will probably make the difference between the old age and the new era of transplantation but, at the moment, reports remain anecdotal.…”

Section: Ex-vivo Conditioningmentioning

confidence: 99%

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Ferraresso¹,

Favi²

2015

J Transplant Technol Res

View full text Add to dashboard Cite

Static cold storage is currently the most used method of organ preservation worldwide. However, cutting edge technology and dramatic changes in the donor pattern have lately renewed the interest toward hypothermic machine perfusion. Marginal and cardiac death donors show higher rates of primary non function and delayed graft function compared to standard criteria donors. In this setting, machine perfusion may offer several theoretical advantages such as improved organ preservation, continuous graft evaluation, and ex-vivo conditioning of the graft before implantation. These topics have been recently reassessed by several studies. In particular, perfusion characteristics (renal resistance) and perfusate biomarker concentrations (lactate dehydrogenase, aspartate aminotransferase, heart-type fatty acid binding protein, and IL-18) during machine preservation, proved to be reliable tools to rule out graft viability and predict outcomes after transplantation. Treatment strategies acting on tissue repair, cell metabolism, and allorecognition pathway are also under investigation with promising results. Machine perfusion has finally shown its real potential however, stronger evidences and updated cost-effectiveness analysis are needed to fully support its role for the next future.

show abstract

Normalization of nitric oxide flux improves physiological parameters of porcine kidneys maintained on pulsatile perfusion

Cited by 9 publications

References 40 publications

One-year results of a prospective, randomized trial comparing two machine perfusion devices used for kidney preservation

One-year results of a prospective, randomized trial comparing two machine perfusion devices used for kidney preservation

Are We Frozen in Time? Analysis of the Utilization and Efficacy of Pulsatile Perfusion in Renal Transplantation

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Contact Info

Product

Resources

About