Prediction of kidney nonfunction after transplantation with machine perfusion preservation

Kozaki, Koichi; Sakurai, E; Kubota, K; Iwamoto, Hitoshi; Hama, K.; Narumi, Y; Uchiyama, M; Kikuchi, Kenjiro; Degawa, Hisakazu; Matsuno, Naoto; Kozaki, M; Nagao, Toshiyasu

doi:10.1016/s0041-1345(99)00955-0

Cited by 18 publications

(16 citation statements)

References 4 publications

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“…Of these, nine [52][53][54][55][56][57][58][59][60] were published between 1974 and 1981, reporting seven studies of the use of perfusate flow characteristics and biochemical markers. A further 17 papers published since 1993 have been identified, [61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77] reporting 11 studies. Details of all studies are given in Table 4.…”

Section: Papers Identified For Reviewmentioning

confidence: 99%

The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors

Wight

Chilcott²,

Holmes³

et al. 2003

Health Technol Assess

125

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email.Paying by official purchase order You can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heartbeating and non-heart-beating donors This report should be referenced as follows:Wight J, Chilcott J, Holmes M, Brewer N. The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors. Health Technol Assess 2003;7(25). Health Technology Assessment is indexed in Criteria for inclusion in the HTA monograph seriesReports are published in the HTA monograph series if (1) they have resulted from work commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. O2Objectives: To evaluate the clinical and costeffectiveness of machine perfusion (MP) compared to cold storage (CS), as a means of preserving kidneys prior to transplantation. Transplantation of kidneys from both heart-beating donors (HBDs) and non-heartbeating donors (NHBDs) is considered. Finally to review whether the use of MP can allow valid testing of kidney viability prior to transplantation. Data sources: Fifteen electronic bibliographic databases were searched. The reference lists of relevant articles and sponso...

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Section: Papers Identified For Reviewmentioning

confidence: 99%

The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors

Wight

Chilcott²,

Holmes³

et al. 2003

Health Technol Assess

125

View full text Add to dashboard Cite

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“…Nonetheless, given the clear need to reduce unnecessary organ refusals, a more forwardthinking hypothesis is that biomarkers like perfusate pi-GST might differentiate between recoverable versus unrecoverable kidney injury more precisely than current perfusion parameters. Many OPOs and prospective transplant centers pay close attention to perfusion parameters at the time of organ offer (12,(15)(16)(17). Consequently, most observational studies that assess the utility of perfusion parameters in predicting allograft outcomes are limited by potential selection bias and confounding by indication, and the current study is no different in this regard.…”

Section: Discussionmentioning

confidence: 92%

“…We assessed the effect of perfusion duration on the association between post pi-GST and DGF via stratified analysis with three duration categories (<8, [8][9][10][11][12][13][14][15][16], and >16 hours). The RR estimate for DGF with each unit increase in Log e (post pi-GST) were comparable for each category in the range of 1.3 to 1.6.…”

Section: Associations Of Perfusate Gst Pump Parameters and The Outcomentioning

confidence: 99%

Glutathione S-Transferase Iso-Enzymes in Perfusate From Pumped Kidneys Are Associated With Delayed Graft Function.

Hall

Bhangoo

Reese³

et al. 2014

Transplantation

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Accurate and reliable assessment tools are needed in transplantation. The objective of this prospective, multicenter study was to determine the associations of the alpha and pi iso-enzymes of glutathione S-transferase (GST), measured from perfusate solution at the start and end (base and post) of kidney allograft machine perfusion, with subsequent delayed graft function (DGF). We also compared GST iso-enzyme perfusate levels from discarded versus transplanted kidneys. A total of 428 kidneys were linked to outcomes as recorded by the United Network of Organ Sharing. DGF, defined as any dialysis in the first week of transplant, occurred in 141 recipients (32%). Alpha and pi-GST levels significantly increased during machine perfusion. The adjusted relative risks (95% confidence interval) of DGF with each log-unit increase in base and post pi-GST were 1.14 (1.0-1.28) and 1.33 (1.02-1.72), respectively. Alpha-GST was not independently associated with DGF. There were no significant differences in GST values between discarded and transplanted kidneys, though renal resistance was significantly higher in discarded kidneys. We NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript found pi-GST at the end of machine perfusion to be independently associated with DGF. Further studies should elucidate the utility of GST for identifying injured kidneys with regard to organ allocation, discard and recipient management decisions.

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“…Nuestro grupo de trabajo tiene grandes expectativas en la conservación mediante perfusión, pues son varias las experiencias que refieren mejores resultados con este tipo de preservación 13,44 . Además, es en los órga-nos procedentes de donantes en parada cardiaca, en los que la posibilidad de evaluarlos para analizar su viabilidad resulta una herramienta muy útil a la hora de discriminar entre órganos de características potencialmente subóptimas 45 . Durante años el único criterio válido para demostrar la viabilidad de un riñón que ha sido trasplantado era el propio trasplante.…”

Section: Discussionunclassified

Caracterización histológica y hemodinámica del injerto con isquemia caliente según el método de preservación

et al. 2008

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órganos de donantes a corazón parado abre una vía para solucionar la escasez de órganos para trasplante. Por la naturaleza de estos donantes los riñones sufren un periodo variable de isquemia normotérmica (IN) antes de su extracción, que puede dañar el injerto y condicionar su supervivencia. Minimizar el daño producido al riñón durante la extracción, los diferentes tipos de conservación hipotérmica y su posterior trasplante resulta clave para mejorar los resultados obtenidos con este tipo de injertos.Pretendemos evaluar mediante un modelo experimental, que somete al injerto renal a un periodo de IN, las consecuencias estructurales y hemodinámicas de la perfusión hipotérmica (PH) frente a la hipotermia simple (HS). Todo el procedimiento fue monitorizado y registrado mediante un sistema informatizado. La resistencia vascular renal (RVR) y el flujo vascular renal (FVR) fueron registrados en tiempo real tras el desclampaje. Llevamos a cabo estudio histológico mediante microscopía convencional y electrónica.Resultados: Observamos 2 patrones evolutivos post-trasplante: 1. Incremento inicial de RVR con descenso posterior e incremento del flujo vascular: órganos con IN y PH previa al trasplante (grupo B) // órganos sin isquemia previa y trasplante (grupo C-control). Microscopía convencional-electrónica: integridad túbulo-endotelial.2. Descenso inicial de RVR con incremento posterior: órganos con IN y trasplante directo (A)//órganos con isquemia previa e HS de 60 min. (D). Alteraciones túbulo-endoteliales en micro convencional-electrónica.Conclusiones: La PH en bomba preserva mejor, a nivel experimental, la ultraestructura túbulo-endotelial de los riñones sometidos a IN prolongada. La hemodinámica post-trasplante de los órganos sometidos isquemia y PH sigue un patrón similar a la de los órganos sin IN previa y trasplantados directamente.Palabras clave: Isquemia normotérmica. Preservación de órganos. ABSTRACT HYSTOLOGIC AND HEMODYNAMIC ASPECTS OF WARM ISCHEMIC GRAFT IN RELATION TO THE PRESERVATION METHODObjective: The non-heart-beating donor has been proposed as a solution to donor shortage for renal transplantation. Because the nature of such donors, the kidneys so derived have been damaged by primary warm ischemia (WI), and so potentially they may never function. Minimizing graft injury is especially important in case of transplantation form marginal donors because of a high rate of delayed graft function or primary nonfunction. The aim of this experimental study is to assess the structural and hemodynamic consequences of hypothermic perfusion (HP) versus cold storage (CS), in renal allograft after a period of WI.Material and Methods: We used 20 mini-pigs. WI was achieved by vascular pedicle occlusion during 45 min. We divided organs in 4 groups: A (n=5), kidneys with WI and then transplanted; group B (n=5), grafts with WI and implanted after HP with Belzer solution in our computerized perfusion system. Group C-control, (n=5) transplanted without WI and D (n=5) with WI and 60 min of CS in UW-Viaspan solution.All the pro...

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Prediction of kidney nonfunction after transplantation with machine perfusion preservation

Cited by 18 publications

References 4 publications

The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors

The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors

Glutathione S-Transferase Iso-Enzymes in Perfusate From Pumped Kidneys Are Associated With Delayed Graft Function.

Caracterización histológica y hemodinámica del injerto con isquemia caliente según el método de preservación

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