The mechanism of action of retrograde oxygen persufflation in renal preservation

Influence of Oxygen Concentration During Hypothermic Machine Perfusion on Porcine Kidneys From Donation After Circulatory Death

“…Major influence is attributed to the maintenance of energetic homeostasis during ischemic preservation (20,21). Application of oxygen, that is, provision of sufficient end acceptor of electrons for the mitochondrial respiratory chain, should foster cellular ability to generate adenosin triphosphate, thus helping to maintain energy homeostasis and renal integrity as seen by gaseous oxygenation (22). Further beneficial mechanisms of HMP include shear stress in the vessels (23) and control of acidosis (24,25).…”

Persufflation (or gaseous oxygen perfusion) as a method of organ preservation

“…This group developed a fairly elaborate canine autotransplantation model that they used to examine the effects of varying lengths of WIT (30 and 60 minutes) in combination with R-PSF for 24 or 48 hours duration [64; 68; 69]. They also explored the differences between pure oxygen, air, nitrogen and helium PSF on post-transplant renal function and survival (for up to 3 months).…”

“…In an attempt to further elucidate the mechanism of preservation by PSF, Pegg et al carried out an interesting study in 1989 in which they compared 24 hours of SCS to 24 hours of R-PSF following 60 minutes of WIT in an ex vivo rabbit kidney model [64]. Their hypothesis was that gaseous oxygen PSF enables continued aerobic respiration and that hypothermic conditions only slow the rates governing energy turnover.…”

Chemical Oxygenation of Pancreatic Tissue Prior to Islet Isolation and Transplantation

“…(2) Persufflation. The continuous gaseous supply of humidified oxygen via the vessels of explanted kidneys or livers represents another approach to improve oxidative energy metabolism during ischemia (Minor and Isselhard, 1996, Pegg et al, 1989, Minor et al, 2002. Recently, a pilot study was performed to utilize persufflation to rescue marginal donor livers for transplantation into patients (Treckmann et al, 2008).…”