Mesnard Benoit, Ogbemudia Etohan, Bruneau Sarah, Le Bas-Bernardet Stéphanie, Minault David, Hervouet Jeremy, Kervella Delphine, Masset Christophe, Cantarovich Diego, Rigaud Jérôme, Badet Lionel, Friend Peter, Ploeg Rutger, Blancho Gilles, Hunter James, Prudhomme Thomas, Branchereau Julien
Department of Urology and Transplantation Surgery, Nantes University Hospital, Nantes, France.
Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, Nantes, France.
Transplantation. 2025 Jan 1;109(1):e1-e10. doi: 10.1097/TP.0000000000005111. Epub 2024 Jun 24.
The clinical standard for pancreas preservation for transplantation is static cold storage (SCS). Oxygenation during preservation has been shown to be advantageous in clinical studies. This study evaluates the efficiency of different oxygenation modalities during hypothermic pancreas preservation.
Thirty-two porcine pancreases were procured in a controlled donation after circulatory death model and were divided to be preserved in 8 groups: (1) SCS, (2) hypothermic machine perfusion (HMP), (3) hypothermic oxygenated machine perfusion (HOPE) with 21% oxygen, (4) HOPE and 100%, (5) SCS and oxygen carrier, M101, (6) HMP and M101, (7) HOPE 21% and M101, and (8) HOPE 100% and M101. All the groups underwent 24 h of hypothermic preservation, followed by 2 h of normothermic reperfusion. Oxygen partial pressures were assessed using parenchymal probes. Perfusion parameters, perfusate samples, and tissue biopsies were analyzed.
This study showed that HMP was linked to higher tissue oxygen partial pressures, lower succinate levels, and better reperfusion parameters. Furthermore, the addition of M101 to either SCS or HMP was associated with lower succinate and creatinine phosphokinase accumulation, suggesting a protective effect against ischemia.
Our research has demonstrated the efficacy of machine perfusion in hypothermic conditions in providing oxygen to the pancreas during preservation and conditioning the pancreatic microvasculature for reperfusion during transplantation. Furthermore, the addition of M101 suggests a protective effect on the graft from ischemia.
胰腺移植保存的临床标准是静态冷藏（SCS）。临床研究表明，保存期间的氧合具有优势。本研究评估低温胰腺保存期间不同氧合方式的效率。
在循环死亡模型后的可控捐献中获取32个猪胰腺，并分为8组进行保存：（1）SCS，（2）低温机器灌注（HMP），（3）含21%氧气的低温氧合机器灌注（HOPE），（4）HOPE和100%氧气，（5）SCS和氧载体M101，（6）HMP和M101，（7）HOPE 21%和M101，以及（8）HOPE 100%和M101。所有组均进行24小时低温保存，随后进行2小时常温再灌注。使用实质探针评估氧分压。分析灌注参数、灌注液样本和组织活检。
本研究表明，HMP与更高的组织氧分压、更低的琥珀酸水平和更好的再灌注参数相关。此外，在SCS或HMP中添加M101与更低的琥珀酸和肌酸磷酸激酶积累相关，提示对缺血有保护作用。
我们的研究证明了机器灌注在低温条件下在保存期间为胰腺提供氧气以及在移植期间使胰腺微血管系统适应再灌注方面的有效性。此外，添加M101提示对移植物有缺血保护作用。
