Comparison of Temperatures for Optimal Preservation of Donor Kidneys during Oxygenated Pulsatile Perfusion
1Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Centre, London, ON, Canada
2Multi-Organ Transplant Program, London Health Sciences Centre, London, ON, Canada
3Western University, Canada, London, ON, Canada.
Meeting: 2018 American Transplant Congress
Abstract number: D24
Keywords: Ischemia, Kidney transplantation, Renal function, Renal injury
Session Information
Session Name: Poster Session D: Immunosuppression Preclinical Studies
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background. The current methods of preserving DCD renal allografts in either static cold solution or hypothermic pulsatile perfusion are unable to adequately protect the kidney against ischemia-reperfusion injury (IRI). This study was aimed to investigate the impact of oxygenated blood perfusion at different temperatures in a porcine model of transplantation.
Methods. DCD condition was simulated in a large male Landrace pig by cross-clamping the renal pedicle for 30 min. The left kidney was flushed with HTK solution and subjected to cold storage for 4h. The Right kidney was cannulated for pulsatile oxygenated perfusion with syngeneic blood for 4h in 15[deg]C, 22[deg]C and 37[deg]C. To mimic reperfusion post-transplant, all kidneys were reperfused with oxygenated whole blood for 4h in 37[deg]C.
Results. Compared with all other groups, 22[deg]C perfusion resulted in reduced ATN and TUNEL in histology sections, attenuated kidney damage markers (KIM1 and NGAL), and decreased urinary protein excretion. In addition to the high ATN score (60-75%), poor blood flow and thrombosis were also observed after reperfusion in control kidneys stored at 40C. While a modest improvement was reported in 37[deg]C (46-55% ATN), intra-renal hemorrhage was common in this temperature. Kidneys stored at 15[deg]C thrombosed in 2hrs and incapacitated further perfusion. Martius Scarlet Blue (MSB) staining confirmed that 22[deg]C was found to be the optimal condition for perfusion without hemorrhage and blood clot formation.
Conclusions. This study demonstrated that kidneys preserved at room temperature (̴ 22[deg]C) with oxygenated blood reduced IRI and provided optimal method of preservation of kidneys procured via DCD.
CITATION INFORMATION: Bhattacharjee R., Richard-Mohamed M., Ruthirakanthan A., Mayer R., Luke S., Sharma H., TunAbraham M., Alharbi B., Haig A., Luke P. Comparison of Temperatures for Optimal Preservation of Donor Kidneys during Oxygenated Pulsatile Perfusion Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Bhattacharjee R, Richard-Mohamed M, Ruthirakanthan A, Mayer R, Luke S, Sharma H, TunAbraham M, Alharbi B, Haig A, Luke P. Comparison of Temperatures for Optimal Preservation of Donor Kidneys during Oxygenated Pulsatile Perfusion [abstract]. https://atcmeetingabstracts.com/abstract/comparison-of-temperatures-for-optimal-preservation-of-donor-kidneys-during-oxygenated-pulsatile-perfusion/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress