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Hypothermic Machine Perfusion of Kidney Grafts: Which Pressure is Preferred?

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Abstract

To assess the effect of the perfusion pressure (PP) during machine perfusion (MP) on the preservation quality of kidney grafts, we compared mean PPs of 25 and 30 mmHg using a porcine autotransplantation model. After assessment of the microcirculation, animals underwent left nephrectomy. Thereafter, kidneys were washed out followed by 20 h of MP at 25 mmHg (MP25, n = 7) or 30 mmHg (MP30, n = 7) using a novel MP system for hypothermic pulsatile perfusion. After MP preservation, the contralateral kidneys were removed and the preserved kidneys heterotopically autotransplanted. Ten minutes after reperfusion, the microcirculation was reassessed. Seven days posttransplant, animals were euthanized and the kidney grafts removed for histological analysis. MP using a mean PP of 25 mmHg resulted in higher capillary blood flow after reperfusion. In the MP30 group, 6 out of 7 animals survived, whereas in the MP25 group all animals survived. Overall, improvement in recovery of renal function and a better preservation of structural integrity were seen in the MP25 group compared to the MP30 group. Using a novel system for hypothermic MP, a mean PP of 25 mmHg is preferred over a mean PP of 30 mmHg.

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Abbreviations

PP:

Perfusion pressure

MP:

Machine perfusion

CS:

Cold storage

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Acknowledgments

The authors would like to thank Mario Sitzia, Wei Lai, Mareike Schulz, and Ute Lohmer for their continuous support. This study was in part sponsored by Doorzand Medical Innovations BV, Amsterdam, The Netherlands (the company ceased operations as per August 2008).

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Authors and Affiliations

  1. Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    B. M. Doorschodt & R. H. Tolba

  2. Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    M. C. J. M. Schreinemachers & S. Florquin

  3. Chair for Computational Analysis of Technical Systems, RWTH-Aachen University, Schinkelstr. 2, 52062, Aachen, Germany

    M. Behbahani

  4. Institute of Neuropathology, RWTH-Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    J. Weis

  5. Institute of Bioengineering and Biomechanics Laboratory, Aachen University of Applied Sciences, Heinrich-Mußmann-Str. 1, 52428, Jülich, Germany

    M. Staat

Authors
  1. B. M. Doorschodt
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  2. M. C. J. M. Schreinemachers
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  3. M. Behbahani
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  4. S. Florquin
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  5. J. Weis
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  6. M. Staat
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  7. R. H. Tolba
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Corresponding author

Correspondence to R. H. Tolba.

Additional information

Associate Editor Stefan Jockenhoevel oversaw the review of this article.

This study was performed at the House of Experimental Therapy, University Clinic of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany and in part at the affiliations mentioned above.

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Doorschodt, B.M., Schreinemachers, M.C.J.M., Behbahani, M. et al. Hypothermic Machine Perfusion of Kidney Grafts: Which Pressure is Preferred?. Ann Biomed Eng 39, 1051–1059 (2011). https://doi.org/10.1007/s10439-010-0228-7

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  • DOI: https://doi.org/10.1007/s10439-010-0228-7

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