Abstract
You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2017MP06-20 RANDOMIZED EXPERIMENTAL STUDY COMPARING NON-OXYGENATED VS OXYGENATED HYPOTHERMIC MACHINE PERFUSION IN A TYPE III NON-HEART-BEATING DONOR PIG MODEL OF AUTOTRANSPLANTATION. Vital Hevia, Victoria Gomez, Maria Laura Garcia-Bermejo, Sara Alvarez, Francisco Donis, Victor Diez, Ana Saiz, Adolfo Martinez, and Francisco Javier Burgos Vital HeviaVital Hevia More articles by this author , Victoria GomezVictoria Gomez More articles by this author , Maria Laura Garcia-BermejoMaria Laura Garcia-Bermejo More articles by this author , Sara AlvarezSara Alvarez More articles by this author , Francisco DonisFrancisco Donis More articles by this author , Victor DiezVictor Diez More articles by this author , Ana SaizAna Saiz More articles by this author , Adolfo MartinezAdolfo Martinez More articles by this author , and Francisco Javier BurgosFrancisco Javier Burgos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.265AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hypothermic machine perfusion (HMP) reduces risk of delayed graft function (DGF) and improves graft survival. Cold reduces oxygen requirement, although metabolic rate remains around 10% and consequently hypoxia would result a source of tissue damage. Hence, the concept of supplying O2 during perfusion is growing, because it would combine active circulation of dissolved oxygen in the perfusate. Oxygenated HMP could allow ATP resynthesis.The aim of the study was to compare HMP with or without oxygen in a pig model of kidney autotransplantation, reproducing conditions of type III non-heart-beating donor (NHBD) METHODS Porcine model of type III NHBD autotransplantation approved by animal ethical committee. 6 female pigs randomized to HMP with or without O2. Left kidney retrieval after 30 min of warm ischemia time (WIT). Kidney was cold-flushed with Celsior® and preserved in LifePort® for 22 h. Afterward, nephrectomy of the remaining right kidney and the transplant of the preserved left kidney in an orthotopic manner were performed. Perfusion conditions are measured with serial perfusate gasometry and miRNAs expression, as well as hemodynamic machine parameters. Serum levels of creatinine are measured every 2 days. After sacrifice, pathology exam was carried out RESULTS Fig. 1 shows Cr evolution, with a peak 2-3 days after transplant. Oxygenated HMP (pigs 1, 5, 6) has shown nearly significant differences in flow: 73.3 vs 46.7 (p= 0.05) and RI: 0.36 vs 0.54 (p=0.05) at the end of perfusion. Fig. 1 shows histological analysis of kidneys and miR10a expression. The increased expression of miR10a (lower DCTs) that has been linked to cell proliferation and tubular repair is correlated with the presence of severe ATN in animal 2. CONCLUSIONS In our preliminary results, oxygenated HMP has shown nearly significant differences in flow and RI at the end of perfusion, as well as better functional results. ATN development was linked to increased expression of miR10a that would make it a biomarker for graft outcome. Similarly, oxygenated allografts have shown lower miR10a expression correlating with less tissue damage, so they could be a useful tool for monitoring oxygen effects in kidney perfusion © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e81 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Vital Hevia More articles by this author Victoria Gomez More articles by this author Maria Laura Garcia-Bermejo More articles by this author Sara Alvarez More articles by this author Francisco Donis More articles by this author Victor Diez More articles by this author Ana Saiz More articles by this author Adolfo Martinez More articles by this author Francisco Javier Burgos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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