Normothermic machine perfusion of ischaemically damaged porcine kidneys with autologous, allogeneic and human red blood cells
M.B.F. Pool, L. Hartveld, H.G.D. Leuvenink, C. Moers
Friday 16 march 2018
10:25 - 10:30h
at Willem Burger Foyer
Categories: Basic, Session (poster)
Parallel session: Poster session 8: Basic translational research
An increasing amount of research is being done to investigate normothermic machine perfusion (NMP) as a preservation method to bridge the period between organ retrieval and transplantation. In porcine kidney auto-transplant models red blood cells (RBCs) are required for ex-vivo NMP. As large quantities of RBCs are needed, utilising autologous RBCs would imply lethal exsanguination of the pig that is donor and recipient-to-be in the same experiment. The purpose of this study was to determine if an isolated porcine kidney can also be perfused with allogeneic or human RBCs instead.
Porcine kidneys, autologous and allogeneic blood were obtained from a local slaughterhouse. Human RBCs (Opos), were provided by our transfusion laboratory. Warm ischaemia time was standardised at 20 min and subsequent hypothermic machine perfusion with UW-MP lasted 1,5-2,5 hrs. Next, kidneys underwent NMP at 37ºC during 7 hrs in a recirculating circuit with either washed, leukocyte depleted autologous, allogeneic, or human RBCs (n=5 per group). Other components of the perfusate were Williams’ Medium E, albumin, creatinine and Augmentin. During perfusion kidneys were functional and produced urine.
No macroscopic adverse reactions were observed). ASAT was significantly higher in the xeno group (p=0.01). LDH release, peripheral renal resistance and fractional excretion of sodium did not differ significantly between groups. Creatinine clearance was significantly higher in the xeno group in comparison with the other groups (p= 0.02), but not in comparison with the autologous group alone. The concentration of albumin in the urine was significantly and substantially higher in the xeno group (p<0.005). Renal histology revealed acute tubular necrosis in all groups. There were signs of glomerular hyperfiltration in the xeno group.
In conclusion, perfusion of porcine kidneys with RBCs of different origin proved feasible. However, laboratory analysis and histology revealed more damage in the xeno group compared to the other two groups. These results indicate that the use of allogeneic RBCs is preferable to human RBCs in a situation where autologous RBCs cannot be used for NMP.
