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Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review

This scoping review summarizes what is known about kidney metabolism during hypothermic perfusion preservation. Papers studying kidney metabolism during hypothermic (<12 °C) perfusion were identified (PubMed, Embase, Web of Science, Cochrane). Out of 14,335 initially identified records, 52 were i...

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Autores principales: Verstraeten, Laurence, Den abt, Rutger, Ghesquière, Bart, Jochmans, Ina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253488/
https://www.ncbi.nlm.nih.gov/pubmed/37297808
http://dx.doi.org/10.3390/jcm12113613
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author Verstraeten, Laurence
Den abt, Rutger
Ghesquière, Bart
Jochmans, Ina
author_facet Verstraeten, Laurence
Den abt, Rutger
Ghesquière, Bart
Jochmans, Ina
author_sort Verstraeten, Laurence
collection PubMed
description This scoping review summarizes what is known about kidney metabolism during hypothermic perfusion preservation. Papers studying kidney metabolism during hypothermic (<12 °C) perfusion were identified (PubMed, Embase, Web of Science, Cochrane). Out of 14,335 initially identified records, 52 were included [dog (26/52), rabbit (2/52), pig (20/52), human (7/52)]. These were published between 1970–2023, partially explaining study heterogeneity. There is a considerable risk of bias in the reported studies. Studies used different perfusates, oxygenation levels, kidney injury levels, and devices and reported on perfusate and tissue metabolites. In 11 papers, (non)radioactively labeled metabolites (tracers) were used to study metabolic pathways. Together these studies show that kidneys are metabolically active during hypothermic perfusion, regardless of the perfusion setting. Although tracers give us more insight into active metabolic pathways, kidney metabolism during hypothermic perfusion is incompletely understood. Metabolism is influenced by perfusate composition, oxygenation levels, and likely also by pre-existing ischemic injury. In the modern era, with increasing donations after circulatory death and the emergence of hypothermic oxygenated perfusion, the focus should be on understanding metabolic perturbations caused by pre-existing injury levels and the effect of perfusate oxygen levels. The use of tracers is indispensable to understanding the kidney’s metabolism during perfusion, given the complexity of interactions between different metabolites.
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spelling pubmed-102534882023-06-10 Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review Verstraeten, Laurence Den abt, Rutger Ghesquière, Bart Jochmans, Ina J Clin Med Systematic Review This scoping review summarizes what is known about kidney metabolism during hypothermic perfusion preservation. Papers studying kidney metabolism during hypothermic (<12 °C) perfusion were identified (PubMed, Embase, Web of Science, Cochrane). Out of 14,335 initially identified records, 52 were included [dog (26/52), rabbit (2/52), pig (20/52), human (7/52)]. These were published between 1970–2023, partially explaining study heterogeneity. There is a considerable risk of bias in the reported studies. Studies used different perfusates, oxygenation levels, kidney injury levels, and devices and reported on perfusate and tissue metabolites. In 11 papers, (non)radioactively labeled metabolites (tracers) were used to study metabolic pathways. Together these studies show that kidneys are metabolically active during hypothermic perfusion, regardless of the perfusion setting. Although tracers give us more insight into active metabolic pathways, kidney metabolism during hypothermic perfusion is incompletely understood. Metabolism is influenced by perfusate composition, oxygenation levels, and likely also by pre-existing ischemic injury. In the modern era, with increasing donations after circulatory death and the emergence of hypothermic oxygenated perfusion, the focus should be on understanding metabolic perturbations caused by pre-existing injury levels and the effect of perfusate oxygen levels. The use of tracers is indispensable to understanding the kidney’s metabolism during perfusion, given the complexity of interactions between different metabolites. MDPI 2023-05-23 /pmc/articles/PMC10253488/ /pubmed/37297808 http://dx.doi.org/10.3390/jcm12113613 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Verstraeten, Laurence
Den abt, Rutger
Ghesquière, Bart
Jochmans, Ina
Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title_full Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title_fullStr Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title_full_unstemmed Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title_short Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review
title_sort current insights into the metabolome during hypothermic kidney perfusion—a scoping review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253488/
https://www.ncbi.nlm.nih.gov/pubmed/37297808
http://dx.doi.org/10.3390/jcm12113613
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