Hypothermic Machine Perfusion Preservation of the DCD Kidney: Machine Effects.
Hypothermic Machine Perfusion Preservation of the DCD Kidney: Machine Effects.
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DOI：
10.1155/2013/802618
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发表时间：
2013
影响因子：
2.5
通讯作者：
Mangino MJ
中科院分区：
文献类型：
--
作者：
Lindell SL;Muir H;Brassil J;Mangino MJ
目的.来自DCD供体的肾脏代表了一个重要的库，但存在保存问题。本研究的目的是测试机器类型对DCD肾脏低温保存的重要性。方法.使用标准灌注方案，在ORS LifePort或沃茨RM 3上对成年比格犬肾脏进行45分钟的原位热缺血，然后进行24小时的低温灌注（Belzer-MPS溶液）。然后自体移植肾脏，并在对侧肾切除术后7天内评估肾功能。结果两种泵的肾血管阻力无差异。24小时后，LifePort灌注液中的氧分压和氧输送显著低于RM 3，但不足以改变乳酸盐的产生。LifePort的运行温度明显低于RM 3（2°对5°C）。RM 3的动脉压波形与LifePort的波形有质的不同。移植后的保存损伤在两种器械之间没有差异。当LifePort变更为非脉动流时，与RM 3相比，肾脏显示出明显更大的保存损伤。结论. LifePort和RM 3均可用于DCD肾脏的低温机器灌注保存，只要占空比保持脉动，结果相同。
Purpose. Kidneys from DCD donors represent a significant pool, but preservation problems exist. The study objective was to test the importance of machine type for hypothermic preservation of DCD kidneys. Methods. Adult Beagle dog kidneys underwent 45 minutes of warm in situ ischemia followed by hypothermic perfusion for 24 hours (Belzer-MPS Solution) on either an ORS LifePort or a Waters RM3 using standard perfusion protocols. Kidneys were then autotransplanted, and renal function was assessed over 7 days following contralateral nephrectomy. Results. Renal vascular resistance was not different between the two pumps. After 24 hours, the oxygen partial pressure and oxygen delivery in the LifePort perfusate were significantly lower than those in the RM3 but not low enough to change lactate production. TheLifePort ran significantly colder than RM3 (2° versus 5°C). The arterial pressure waveform of the RM3 was qualitatively different from the waveform of the LifePort. Preservation injury after transplantation was not different between the devices. When the LifePort was changed to nonpulsatile flow, kidneys displayed significantly greater preservation injury compared to RM3. Conclusions. Both LifePort and RM3 can be used for hypothermic machine perfusion preservation of DCD kidneys with equal outcomes as long as the duty cycle remains pulsatile.