Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model
Rapid sampling microdialysis as a novel tool for parenchyma assessment during static cold storage and hypothermic machine perfusion in a translational ex vivo porcine kidney model
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DOI：
10.1016/j.jss.2015.07.004
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发表时间：
2016-01-01
影响因子：
2.2
通讯作者：
Papalois, Vassilios
中科院分区：
文献类型：
--
作者：
Hamaoui, Karim;Gowers, Sally;Papalois, Vassilios
工作背景：在肾移植中，为了避免不必要的边缘器官丢弃，最大限度地提高移植物的效果，保存期间的活力评估是必要的。为了满足这一需求，我们开发了一种基于快速采样微透析（rsMD）分析仪的新型系统，该分析仪允许连续组织监测和测量细胞损伤的代谢标志物。我们的目的是开发一种工具，允许准确评估的组织代谢和器官活力在preservationperiod.Methods：22猪肾进行15分钟的热缺血进行24小时的静态冷藏（SCS）或10小时的低温机灌注（HMP）。保存后，允许组织温度被动升高至环境温度作为缺血性挑战。皮质和髓质的代谢进行了监测，在整个在线测量的乳酸浓度每60秒。结果：在开始监测，乳酸浓度在15分钟内成功检测。在最初的1.5小时内，SCS（65 μ M）和HMP（124 μ M，P > 0.05）期间的乳酸盐浓度相似，但SCS 10小时后较低（SCS：68 μ M vs HMP：230 μ M，P < 0.001）。变暖的数据表明，HMP肾脏的弹性，随后的温度引起的缺血相比，SCS kidneys.Conclusions：这个初步研究提供了基线缺血配置文件的猪肾脏，同时验证技术的rsMD作为一种工具，在保存过程中的器官活力评估。这些数据表征了SCS和HMP保存的同种异体移植物之间的代谢差异，并有助于阐明HMP在临床上上级SCS的原因，从而允许开发干预措施以增强这些受益。(C)2016 Elsevier Inc. All rights reserved.
Background: Viability assessment during preservation is imperative to avoid unnecessary discard of marginal organs maximizing graft outcomes in kidney transplantation. To address this need, we have developed a novel system based on a rapid sampling micro-dialysis (rsMD) analyzer allowing continuous tissue monitoring and measurement of metabolic markers of cell damage. Our aim was to develop a tool that allows for accurate assessment of tissue metabolism and organ viability in the preservation period.Methods: Twenty-two porcine kidneys subjected to 15 min of warm ischemia underwent either 24 h of static cold storage (SCS) or 10 h of hypothermic machine perfusion (HMP). After preservation, tissue temperature was allowed to passively increase to ambient temperature as an ischemic challenge. Cortical and medullary metabolism was monitored throughout with online measurements of lactate concentrations made every 60 s.Results: On commencement of monitoring, lactate concentrations were successfully detected within 15 mins. During the initial 1.5 h, lactate concentrations were similar during SCS (65 mu M) and HMP (124 mu M, P > 0.05) but lower after 10 h of SCS (SCS: 68 mu M versus HMP: 230 mu M, P < 0.001). Warming data suggest a resilience of HMP kidneys to subsequent temperature induced ischemia compared to SCS kidneys.Conclusions: This preliminary study provides the baseline ischemic profile for porcine kidneys while validating the technique of rsMD as a tool for organ viability assessment during preservation. The data characterize metabolic differences between SCS and HMP preserved allografts and can help elucidate why HMP is clinically superior to SCS allowing development of interventions to augment these benefits. (C) 2016 Elsevier Inc. All rights reserved.