Renal Embolization-Induced Uremic Swine Model for Assessment of Next-Generation Implantable Hemodialyzers.
Renal Embolization-Induced Uremic Swine Model for Assessment of Next-Generation Implantable Hemodialyzers.
复制标题
DOI：
10.3390/toxins15090547
复制
发表时间：
2023-09-04
期刊：
影响因子：
4.2
通讯作者：
Roy S
中科院分区：
文献类型：
--
作者：
Moyer J;Wilson MW;Sorrentino TA;Santandreu A;Chen C;Hu D;Kerdok A;Porock E;Wright N;Ly J;Blaha C;Frassetto LA;Fissell WH;Vartanian SM;Roy S
大型动物肾衰竭的可靠模型对于将下一代肾脏替代疗法（RRT）成功转化为人类至关重要。虽然存在诱导肾衰竭的模型，但没有一个模型针对将装置植入腹膜后脉管系统进行优化。我们成功地试点了从栓塞到植入的方案，首次在猪肾衰竭模型中植入硅纳米孔膜血液透析器（SNMHD）。肾动脉栓塞是近全肾切除术的一种非侵入性方法，可保留装置植入的腹膜后解剖结构。硅纳米孔膜 (SNM) 是一种高效的血液相容性膜，可实现 RRT 的新方法。尤卡坦半岛小型猪接受分阶段双侧肾动脉栓塞以诱导肾衰竭，并通过间歇性血液透析进行治疗。将小型动静脉 SNMHD 原型植入腹膜后。透析液导管在外部通过隧道连接至透析液再循环泵。 SNMHD 清除率通过再循环透析液的间歇采样来确定。通过 SNMHD 的肌酐和尿素清除率分别为 76–105 mL/min/m2 和 140–165 mL/min/m2，无白蛋白渗漏。 SNMHD 中测量的标准化肌酐和尿素清除率可转化为完全可植入的临床规模设备。这项试点研究为临床规模 SNMHD 和其他植入式 RRT 设备的治疗测试开辟了一条道路。
Reliable models of renal failure in large animals are critical to the successful translation of the next generation of renal replacement therapies (RRT) into humans. While models exist for the induction of renal failure, none are optimized for the implantation of devices to the retroperitoneal vasculature. We successfully piloted an embolization-to-implantation protocol enabling the first implant of a silicon nanopore membrane hemodialyzer (SNMHD) in a swine renal failure model. Renal arterial embolization is a non-invasive approach to near-total nephrectomy that preserves retroperitoneal anatomy for device implants. Silicon nanopore membranes (SNM) are efficient blood-compatible membranes that enable novel approaches to RRT. Yucatan minipigs underwent staged bilateral renal arterial embolization to induce renal failure, managed by intermittent hemodialysis. A small-scale arteriovenous SNMHD prototype was implanted into the retroperitoneum. Dialysate catheters were tunneled externally for connection to a dialysate recirculation pump. SNMHD clearance was determined by intermittent sampling of recirculating dialysate. Creatinine and urea clearance through the SNMHD were 76–105 mL/min/m2 and 140–165 mL/min/m2, respectively, without albumin leakage. Normalized creatinine and urea clearance measured in the SNMHD may translate to a fully implantable clinical-scale device. This pilot study establishes a path toward therapeutic testing of the clinical-scale SNMHD and other implantable RRT devices.
登录
查看更多内容
影响因子：
2
作者：
Damasceno-Ferreira, Jose A.;Abreu, Leonardo A. S.;De Souza, Diogo B.
通讯作者：
De Souza, Diogo B.
影响因子：
5
作者：
Chevtchik, Natalia Vladimirovna;Fedecostante, Michele;Stamatialis, Dimitrios
通讯作者：
Stamatialis, Dimitrios
影响因子：
2.9
作者：
Iqbal, Zohora;Kim, Steven;Roy, Shuvo
通讯作者：
Roy, Shuvo
影响因子：
10
作者：
Hill, Kayli;Walker, Samuel N.;Johnson, Dean G.
通讯作者：
Johnson, Dean G.
影响因子：
0.5
作者：
Gómez, Fabian Alejandro;Ballesteros, Luis Ernesto;Estupiñan, Hernando Yesid
通讯作者：
Estupiñan, Hernando Yesid