The use of marginal organs demands optimization of organ storage and quality assessments prior to transplantation. Organs from donors after cardiac death (DCD) are exposed to ischemia, consequently leaving them susceptible to delayed graft function post-transplant. Using persufflation to deliver electrochemically derived humidified, gaseous oxygen to the organ is a promising technique for improving organ preservation due to its ability to alleviate ischemic stress.

A DCD model of porcine donors was used to study effects of kidney persufflation. One kidney was persufflated while the other served as a static cold storage control for 24 hours. Magnetic resonance imaging using gadolinium (gd) perfusion was used as a quality assessment measurement. T1 maps were taken before and after contrast imaging to calculate renal perfusion. Whole organ oxygen consumption rate (WOOCR) was measured by using a hypothermic perfusion loop with SPS-1 maintained at 4-7[deg]C. Perfusion flow rate was set to 80ml/min with an average pressure of 40mmHg at the renal artery and oxygenated with 40% oxygen. Fiberoptic sensors were placed upstream of the arterial and downstream of the venous cannula to measure oxygen partial pressure across the kidney. Biopsies were taken for molecular sequencing and hematoxylin-eosin staining for histology.

Gd-perfusion curves show the persufflated kidney with a descending cortical slope of -2.49 (n=1) while the cold storage kidney had a slope of -1.73 (n=1), indicating a faster clearance rate of Gd in the cortex of the persufflated kidney. WOOCR data for persufflated kidneys were 110.3 ± 51.8 nmol/min*kg (n=6) and the static cold storage was at 78.1 ± 52.1 nmol/min*kg (n=6) with p<0.05, suggesting more viable, oxygen consuming tissue in the persufflated organs. Results for molecular sequencing and the histology scoring are currently pending. Results from imaging and WOOCR indicated that providing oxygen to the organ after ischemic stress can improve viability and perhaps function when compared to its static cold storage counterpart. The current studies are ongoing and aim to further investigate the effects of oxygen supplementation and an effective combination of organ quality assessments.

CITATION INFORMATION: Min C, Steyn L, Pandey A, Harland R, Galons J.-P, Papas K. Persufflation Improves Viability and Function of Porcine Kidneys Relative to Static Cold Storage. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress