Purpose: Recent studies have suggested that EVNP may be utilized to assess and repair marginal donor organs subjected to severe I/R injury. The lack of a small animal model has limited the ability to explore novel applications of EVNP. The purpose of our study is to develop a small animal EVNP system.

Methods: Sprague Dawley rat kidneys were procured en-bloc, cannulated via the distal aorta, placed on a custom platform, and perfused ex-vivo at 37 ◦C for 3 hours. The closed perfusion circuit consisted of a venous reservoir, roller head pump, porous silicon tubing for oxygenation and CO2 exchange, a glass coil heating system and in-line air bubble trap. Perfusate consisted of packed red blood cells (PRBCs), Plasma-Lyte, albumin, parenteral nutrition, insulin, multi-vitamins, heparin and bicarbonate. Exogenous creatinine was added to assess renal function. The optimal perfusate composition was developed by testing varying concentrations of perfusate components on EVNP. The system is flow controlled and pressure regulated. Continuous assessment was via monitoring of hemodynamic parameters, urine output and blood collection for gas exchange and electrolytes.

Results: In development of the optimal perfusate, kidneys placed on EVNP had inconsistent hemodynamics, varied urine output with frequent thrombosis. Kidneys placed on EVNP with optimal perfusate were consistently well-perfused with O2 saturation >98% and normal urine output. Stable hemodynamic status was achieved after 30 minutes and blood creatinine/K+ levels decreased with time as summarized in figure 1. Data (n=6) presented as mean values with standard deviation and compared with linear regression analysis to detect a change in slope.

Conclusion: EVNP in a small animal model is technically feasible and allows for assessment of graft viability and function. This system can be used for pre-clinical exploration of different interventional strategies to treat I/R injury prior to transplantation.

CITATION INFORMATION: Smolin Y, Palma I, Pivetti C, Kabagambe S, Woloszyn J, Chen Y, Boyer T, Palma I, Sageshima J, Santhanakrishnan C, Perez R. Creation of a Small Animal Model of Ex-Vivo Normothermic Perfusion (EVNP) for Treatment of Kidney Ischemia-Reperfusion (I/R) Injury. Am J Transplant. 2016;16 (suppl 3).

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