Successful Transplantation of Human Kidneys Deemed Untransplantable but Resuscitated by Ex Vivo Normothermic Machine Perfusion.
Successful Transplantation of Human Kidneys Deemed Untransplantable but Resuscitated by Ex Vivo Normothermic Machine Perfusion.
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DOI：
10.1111/ajt.13906
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Nicholson ML
中科院分区：
文献类型：
--
作者：
Hosgood SA;Saeb-Parsy K;Hamed MO;Nicholson ML
我们报告了一对因原位灌注不足而拒绝移植的人肾的成功移植，但随后在灌注和体外恒温灌注（EVNP）评估后移植。肾脏来自一名35岁的男性，在循环死亡后捐献。英国所有移植中心都放弃了这两个肾脏。到达肾脏时，微循环中的血液有明显的不完全清除区域，在进一步尝试冲洗它们后仍未清除。肾脏在加热至35.2℃的充氧红细胞基溶液中进行60分钟的EVNP。在EVNP过程中，双肾斑块区清除。左肾平均肾血流量和总尿量分别为68.0 mL/min/100 g和560 mL，右肾平均肾血流量和总尿量分别为59.9 mL/min/100 g和430 mL。根据EVNP灌注参数，认为双肾适合移植。两例移植均无并发症，均具有初始移植物功能。3个月时左肾受体血清肌酐水平为1.2 mg/dl，右肾受体为1.62 mg/dl。EVNP技术可用于评估和抢救以前认为不适合移植的肾脏。体外恒温灌注允许两个肾脏的移植，由于原位灌注不足，所有英国中心都认为这是不可移植的。
We report the successful transplantation of a pair of human kidneys that were declined for transplantation due to inadequate in situ perfusion but subsequently transplanted after perfusion and assessment using ex vivo normothermic perfusion (EVNP). The kidneys were from a 35‐year‐old man, a donation after circulatory death donor. Both kidneys were declined by all UK transplant centers. On arrival, the kidneys had significant areas of incomplete clearance of blood from the microcirculation that did not clear after a further attempt to flush them. Kidneys underwent 60 min of EVNP with an oxygenated packed red blood cell–based solution warmed to 35.2°C. During EVNP, the patchy areas cleared in both kidneys. The mean renal blood flow and total urine output were 68.0 mL/min/100 g and 560 mL in the left kidney and 59.9 mL/min/100 g, 430 mL in the right, respectively. Based on the EVNP perfusion parameters, both kidneys were deemed suitable for transplantation. They were transplanted without any complications, and both recipients had initial graft function. The serum creatinine levels at 3 months were 1.2 mg/dl in the recipient of the left kidney and 1.62 mg/dl in the recipient of the right kidney. EVNP technology can be used to assess and rescue kidneys previously deemed unsuitable for transplantation. Ex vivo normothermic perfusion allows the transplantation of two kidneys deemed untransplantable by all UK centers due to inadequate in situ perfusion.
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影响因子：
7.4
作者：
Hosgood SA;Barlow AD;Dormer J;Nicholson ML
通讯作者：
Nicholson ML
影响因子：
6.2
作者：
Hosgood, Sarah A.;Nicholson, Michael L.
通讯作者：
Nicholson, Michael L.
影响因子：
8.8
作者：
Nicholson, M. L.;Hosgood, S. A.
通讯作者：
Hosgood, S. A.
影响因子：
2.2
作者：
Hosgood, Sarah A.;Patel, Meeta;Nicholson, Michael L.
通讯作者：
Nicholson, Michael L.
影响因子：
9.6
作者：
Hosgood, S. A.;Barlow, A. D.;Nicholson, M. L.
通讯作者：
Nicholson, M. L.