Brief O2 uploading at the onset of continuous HMP results in comparable early graft function compared to continuous active oxygenated HMP and is significantly better than non-active oxygenated HMP or end ischemic O2 supply in a pig auto-transplant model.

Darius, Tom;Vergauwen, Martial;Gianello, Pierre;Buemi, Antoine;Mourad, Michel;et.al.
(2019) 26th BTS Annual Congress 2019 — Location: Antwerp, Belgium (14.March.2019)

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BACKGROUND: The aim of this study was to evaluate the impact of different perfusate oxygen concentrations and timing during continuous hypothermic machine perfusion (HMP) on early graft function in a porcine kidney ischemia-reperfusion auto-transplant model. METHODS: The left kidney of ±40 kg landrace pig was exposed to 30 minutes of warm ischemia by vascular clamping and randomized out to one of 7 studied preservation strategies: 1) 22h static cold storage (SCS), 2) 22h (no active oxygen supply) HMP, 3) 22h oxygenated HMP (HMPO2low)(pO2=220-240mmHg), 4) 20h SCS + 2h HMPO2low, 5) 22h HMPO2high(pO2=700- 800mmHg), 6) 2h HMPO2high+20hHMP, and 7) 20h HMP + 2h HMPO2high. The LifePort Kidney Transporter® was used for all machine perfusion strategies. The kidney was auto-transplanted in a right orthotopic position. RESULTS: The overall effect of each treatment strategy on early graft function expressed as AUC of the serum creatinine of 46 auto-transplants from day 1 until day 13 post-transplantation demonstrated that 2h HMPO2high+20h HMP was comparable with 22h HMPO2high or 22h HMPO2low, but significantly lower than non-active oxygenated HMP (p<0.0001), 20h HMP+2hHMPO2high (p=0.0349) and end ischemic HMPO2 after SCS (p<0.0001). The serum creatinine was significantly lower from day 1 until day 4 after transplantation in the 2h HMPO2high+20h HMP group, the 22h HMPO2low or 22h HMPO2high group but no difference was observed in the 20h HMP+2h HMPO2high group compared to 22h non-active oxygenated HMP. CONCLUSION: Brief O2 uploading at the start might be the best and most convenient oxygenation strategy for continuous HMP to improve early graft function. Pancreatic
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Darius, T., Vergauwen, M., Gianello, P., Buemi, A., De Meyer, M., & Mourad, M. (2019). Brief O2 uploading at the onset of continuous HMP results in comparable early graft function compared to continuous active oxygenated HMP and is significantly better than non-active oxygenated HMP or end ischemic O2 supply in a pig auto-transplant model. 26th BTS Annual Congress 2019, Antwerp, Belgium. https://hdl.handle.net/2078.5/30673