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新型便携式低温搏动灌注保存技术:提高啮齿动物和犬类肾脏的活力与功能。

Novel portable hypothermic pulsatile perfusion preservation technology: Improved viability and function of rodent and canine kidneys.

作者信息

Tolstykh Gleb P, Gelineau Jerry F, Maier Lisa M, Bunegin Leonid

机构信息

Department of Anesthesiology, University of Texas Health Science Center at San Antonio, 78229, USA.

出版信息

Ann Transplant. 2010 Jul-Sep;15(3):35-43.

Abstract

BACKGROUND

A reliable, portable, cost effective device for perfusion preservation of donor organs remains elusive. A portable, organ perfusion device design for hypothermic, machine perfusion (HMP) that successfully supported rodent kidneys for 24 hours was evaluated in canine kidneys.

MATERIAL/METHODS: Freshly recovered rodent and canine kidneys were subjected to 24 hours of HMP or static storage (SS). Organ perfusion and cell membrane integrity were examined in HMP and SS rodent kidneys. Canine kidney function was evaluated in an isolated organ preparation. Oxygen consumption (OC), renal vascular resistance (RVR), and glomerular filtration rates (GFR) were compared.

RESULTS

Perfusion pressure during HMP averaged 16 mmHg with oxygen delivery roughly 4 fold greater than the canine kidney's metabolic requirements. Following 24 hours of preservation, RVR was significantly elevated while OC and GFR were significantly lower in the SS organs compared to the HMP stored or freshly recovered kidneys.

CONCLUSIONS

This organ preservation technology appears to provide an excellent preservation environment for kidneys such that post-transplant delayed graft function is minimized. Additionally, compared to current machine perfusion systems, the preservation system described in this work is significantly reduced in size, weight, and complexity, such that total portability may be possible.

摘要

背景

一种用于供体器官灌注保存的可靠、便携且经济高效的设备仍然难以实现。一种用于低温机器灌注(HMP)的便携式器官灌注设备设计在啮齿动物肾脏上成功支持了24小时,现对犬肾进行评估。

材料/方法:将新鲜回收的啮齿动物和犬肾进行24小时的HMP或静态保存(SS)。对HMP和SS保存的啮齿动物肾脏进行器官灌注和细胞膜完整性检查。在离体器官制备中评估犬肾功能。比较氧耗(OC)、肾血管阻力(RVR)和肾小球滤过率(GFR)。

结果

HMP期间的灌注压力平均为16 mmHg,氧输送量约为犬肾代谢需求的4倍。保存24小时后,与HMP保存或新鲜回收的肾脏相比,SS器官的RVR显著升高,而OC和GFR显著降低。

结论

这种器官保存技术似乎为肾脏提供了一个极佳的保存环境,从而使移植后延迟移植肾功能最小化。此外,与当前的机器灌注系统相比,本研究中描述的保存系统在尺寸、重量和复杂性方面显著降低,因此可能具有完全的便携性。

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