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Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys

BACKGROUND. The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant mo...

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Autores principales: Darius, Tom, Vergauwen, Martial, Mueller, Matteo, Aydin, Selda, Dutkowski, Philipp, Gianello, Pierre, Mourad, Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339262/
https://www.ncbi.nlm.nih.gov/pubmed/32766426
http://dx.doi.org/10.1097/TXD.0000000000001016
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author Darius, Tom
Vergauwen, Martial
Mueller, Matteo
Aydin, Selda
Dutkowski, Philipp
Gianello, Pierre
Mourad, Michel
author_facet Darius, Tom
Vergauwen, Martial
Mueller, Matteo
Aydin, Selda
Dutkowski, Philipp
Gianello, Pierre
Mourad, Michel
author_sort Darius, Tom
collection PubMed
description BACKGROUND. The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model. METHODS. The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO(2)) (n = 8), and 2-hour HMPO(2) + 20-hour HMP (n = 6) using membrane oxygenation in both historical oxygenated control groups. RESULTS. Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po(2) levels during the first 2 hours of HMP with improved flow dynamics. Although the metabolic profile of the perfusate (ie, flavin mononucleotide) and tissue (ie, glutamate, ATP) after brief O(2) uploading at the start of HMP seemed to be slightly better with the use of a membrane oxygenator compared with bubble and interrupted surface oxygenation, both techniques yielded similar, superior early graft function when compared with HMP without active oxygenation. CONCLUSIONS. The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO(2).
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spelling pubmed-73392622020-08-05 Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys Darius, Tom Vergauwen, Martial Mueller, Matteo Aydin, Selda Dutkowski, Philipp Gianello, Pierre Mourad, Michel Transplant Direct Kidney Transplantation BACKGROUND. The aim of this feasibility study was to determine an alternative oxygenation technique (easy, cheap, and compatible with air transport) for membrane oxygenation during hypothermic machine perfusion (HMP) to improve early graft function in a porcine ischemia-reperfusion autotransplant model. METHODS. The left kidney of a ±40- kg pig was exposed to 30 minutes of warm ischemia before 22 hours of preservation and autotransplantation. In the experimental group, oxygenation of the perfusate during HMP was obtained by direct bubble and 30-minute surface oxygenation at start and 1-hour end ischemic (n = 4) and outcome measures compared with historical HMP without active oxygenation (n = 6), 22-hour continuous oxygenated HMP (HMPO(2)) (n = 8), and 2-hour HMPO(2) + 20-hour HMP (n = 6) using membrane oxygenation in both historical oxygenated control groups. RESULTS. Brief bubble and 30-minute surface oxygenation of the perfusate effectively maintained supraphysiological Po(2) levels during the first 2 hours of HMP with improved flow dynamics. Although the metabolic profile of the perfusate (ie, flavin mononucleotide) and tissue (ie, glutamate, ATP) after brief O(2) uploading at the start of HMP seemed to be slightly better with the use of a membrane oxygenator compared with bubble and interrupted surface oxygenation, both techniques yielded similar, superior early graft function when compared with HMP without active oxygenation. CONCLUSIONS. The data presented in this feasibility study support the conclusion that brief bubble and intermittent surface oxygenation could be an alternative oxygenation technique during HMP to achieve an improved kidney graft function compared with HMP without active oxygenation and similar functional outcome when compared with membrane HMPO(2). Wolters Kluwer Health 2020-06-11 /pmc/articles/PMC7339262/ /pubmed/32766426 http://dx.doi.org/10.1097/TXD.0000000000001016 Text en Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Kidney Transplantation
Darius, Tom
Vergauwen, Martial
Mueller, Matteo
Aydin, Selda
Dutkowski, Philipp
Gianello, Pierre
Mourad, Michel
Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title_full Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title_fullStr Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title_full_unstemmed Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title_short Brief Bubble and Intermittent Surface Oxygenation Is a Simple and Effective Alternative for Membrane Oxygenation During Hypothermic Machine Perfusion in Kidneys
title_sort brief bubble and intermittent surface oxygenation is a simple and effective alternative for membrane oxygenation during hypothermic machine perfusion in kidneys
topic Kidney Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339262/
https://www.ncbi.nlm.nih.gov/pubmed/32766426
http://dx.doi.org/10.1097/TXD.0000000000001016
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