Ex-Vivo Subnormothermic Oxygenated Machine Perfusion of Rodent Hindlimb: Feasibility Study to Elongate Preservation Time of Vascularized Composite Allograft
1Surgery, Massachusetts General Hospital/Harvard Medical School, Boston
2Surgery, University Medical Center Groningen, Groningen, Netherlands
3Plastic Surgery, Massachusetts General Hospital/Harvard Medical School, Boston
4Plastic Surgery, European George Pompidou Hospital, Paris, France.
Meeting: 2018 American Transplant Congress
Abstract number: B384
Keywords: Donation, Preservation, Preservation solutions, Rat
Session Information
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
PURPOSE: A pressing challenge in the field of VCA is adequate tissue preservation. Static cold preservation, successfully used in field of solid organ transplantation, greatly jeopardize the quality of VCAs prior to transplantation resulting in allograft rejection. Ex-vivo subnormothermic oxygenated machine perfusion (SNMP) is a novel method of organ preservation known to improve the quality of solid organs prior to transplantation. The aim of this study was to investigate the utility of SNMP on preservation time and resuscitation of ischemic hind limbs in a rat model.
METHODS: Nine rat hind limbs were procured and flushed through the cannulated femoral artery and vein with a heparin/saline (10U/mL) mixture. During 3 hours of SNMP, limbs were perfused by a pressure-controlled system through the femoral artery and the venous outflow was prepared for sample collection. The perfusion solution consisted of William's E medium, bovine serum albumin and polyethylene glycol 2%, enriched with Pen-Strep, L-glutamine, heparin, insulin, hydrocortisone and dexamethasone. Arterial flow and vascular resistance were monitored and perfusion samples for biochemical analysis were collected. Lactate levels and oxygen consumption were evaluated as markers of viability of muscle tissue.
RESULTS: Arterial outflow and vascular resistance remained stable throughout the perfusion, between 0.5-2.0 mL/min and 20-40 mmHg/mL/min respectively. After an initial rise in lactate levels, median lactate levels decreased significantly between the first and second hour of SNMP, 2.52 (IQR 2.11-3.96) and 1.40 (IQR 1.13-2.32) (p=0.02) respectively. After 1 hour of SNMP, median calculated oxygen uptake rate was 20.65 mL/min/gram limb (IQR 6.50-28.47) and remained stable thereafter.
CONCLUSIONS: This study shows that 3 hours ex vivo SNMP of rat hind limb is feasible. Furthermore, SNMP has the potential to both actively preserve and improve overall quality of hind limbs in a rat model. In the future, SNMP may enhance clinical outcome of VCA transplantation.
CITATION INFORMATION: Burlage L., Lellouch A., Tessier S., Pendexter C., Cronin S., Schol M., Randolph M., Porte R., Lantieri L., Cetrulo C., Uygun K. Ex-Vivo Subnormothermic Oxygenated Machine Perfusion of Rodent Hindlimb: Feasibility Study to Elongate Preservation Time of Vascularized Composite Allograft Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Burlage L, Lellouch A, Tessier S, Pendexter C, Cronin S, Schol M, Randolph M, Porte R, Lantieri L, Cetrulo C, Uygun K. Ex-Vivo Subnormothermic Oxygenated Machine Perfusion of Rodent Hindlimb: Feasibility Study to Elongate Preservation Time of Vascularized Composite Allograft [abstract]. https://atcmeetingabstracts.com/abstract/ex-vivo-subnormothermic-oxygenated-machine-perfusion-of-rodent-hindlimb-feasibility-study-to-elongate-preservation-time-of-vascularized-composite-allograft/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress