Assessment of hemodynamic and blood parameters that may reflect macroscopic quality of porcine kidneys during normothermic machine perfusion using whole blood
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
PURPOSE: Using ex vivo normothermic machine perfusion (NMP) with whole blood we assessed marginal porcine kidneys under reperfusion. The aim was to link measureable machine and clinical blood parameters with the currently used visual assessment. This could serve as a baseline for a standardized evaluation score to identify potentially transplantable kidneys in the future.
METHODS: Kidneys and autologous whole blood were procured from slaughterhouse pigs (n = 33) and were perfused for 4 h using NMP. The hemodynamic parameters arterial pressure (AP), renal blood flow (RBF) and intrarenal resistance (IRR) were measured. Activity of aspartate transaminase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and lactate were assessed in blood at 0/1/2/4 h. Kidneys were grouped into "potentially transplantable" (PT) or "not transplantable" (NT) based on their overall macroscopic appearance after NMP by an experienced physician.
RESULTS: PT-kidneys (n = 20) had a significantly lower IRR and higher RBF than NT-kidneys (n = 13). GGT, ALP and LDH did not differ significantly, but at 4 h, AST was significantly higher in PT-kidneys compared to NT-kidneys. Lactate levels kept increasing during NMP in NT-kidneys and were significantly higher at 1/2/4 h than in PT-kidneys.
CONCLUSION: The immediately assessed macroscopic aspects of examined kidneys correlated with hemodynamic parameters, increased lactate and lower AST in this study. In the future, NMP with whole blood could be a useful tool to extend the donor pool by allowing the assessment of otherwise unknown characteristics of marginal kidneys before transplantation.
Details
Original language | English |
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Article number | 471 |
Number of pages | 8 |
Journal | World journal of urology |
Volume | 42 (2024) |
Issue number | 1 |
Publication status | Published - 7 Aug 2024 |
Peer-reviewed | Yes |
External IDs
PubMedCentral | PMC11306647 |
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ORCID | /0000-0002-9011-0822/work/165453808 |
ORCID | /0009-0000-8786-5338/work/165453971 |
Scopus | 85200700004 |
Keywords
Research priority areas of TU Dresden
DFG Classification of Subject Areas according to Review Boards
Subject groups, research areas, subject areas according to Destatis
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Alkaline Phosphatase/blood, Animals, Aspartate Aminotransferases/blood, Hemodynamics/physiology, Kidney Transplantation, Kidney/physiology, L-Lactate Dehydrogenase/blood, Organ Preservation/methods, Perfusion, Renal Circulation/physiology, Swine, gamma-Glutamyltransferase/blood, Normotherme Maschinenperfusion, Niere, Funktionsbewertung, Tiermodell, Reperfusion, Vollblut, Schwein