Sarah A Hosgood1, Michael L Nicholson. 1. Department of Infection, Immunity and Inflammation, Transplant Group, Leicester General Hospital, University of Leicester, Leicester, UK.
Abstract
BACKGROUND: Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case of ex vivo normothermic renal transplant perfusion in man. METHODS: The 62-year-old extended criteria donor died of an intracranial hemorrhage and had undergone cardiopulmonary resuscitation for a 30-min cardiac arrest. After 11 hr of static cold storage and immediately before transplantation, the left kidney was perfused at a mean temperature of 33.9 °C for 35 min with a plasma-free red cell-based solution. The ex vivo perfusion circuit consisted of a centrifugal pump, a membrane oxygenator, and a heat exchanger. The paired right kidney underwent static cold storage for 14 hr. RESULTS: After transplantation, the 55-year-old female recipient of the normothermic perfused kidney had slow graft function but the patient remained dialysis independent; serum creatinine at 3 months posttransplant was 132 μmol/L. The paired static cold-stored kidney was transplanted into a 52-year-old male recipient. This kidney had delayed graft function for a period of 26 days, and the 3-month serum creatinine was 218 μmol/L. CONCLUSION: We conclude that ex vivo normothermic kidney perfusion with a plasma-free red cell-based solution is a feasible method of preservation. This first case was performed without compromising the transplant kidney.
BACKGROUND: Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case of ex vivo normothermic renal transplant perfusion in man. METHODS: The 62-year-old extended criteria donor died of an intracranial hemorrhage and had undergone cardiopulmonary resuscitation for a 30-min cardiac arrest. After 11 hr of static cold storage and immediately before transplantation, the left kidney was perfused at a mean temperature of 33.9 °C for 35 min with a plasma-free red cell-based solution. The ex vivo perfusion circuit consisted of a centrifugal pump, a membrane oxygenator, and a heat exchanger. The paired right kidney underwent static cold storage for 14 hr. RESULTS: After transplantation, the 55-year-old female recipient of the normothermic perfused kidney had slow graft function but the patient remained dialysis independent; serum creatinine at 3 months posttransplant was 132 μmol/L. The paired static cold-stored kidney was transplanted into a 52-year-old male recipient. This kidney had delayed graft function for a period of 26 days, and the 3-month serum creatinine was 218 μmol/L. CONCLUSION: We conclude that ex vivo normothermic kidney perfusion with a plasma-free red cell-based solution is a feasible method of preservation. This first case was performed without compromising the transplant kidney.
Authors: Gregory T Tietjen; Sarah A Hosgood; Jenna DiRito; Jiajia Cui; Deeksha Deep; Eric Song; Jan R Kraehling; Alexandra S Piotrowski-Daspit; Nancy C Kirkiles-Smith; Rafia Al-Lamki; Sathia Thiru; J Andrew Bradley; Kourosh Saeb-Parsy; John R Bradley; Michael L Nicholson; W Mark Saltzman; Jordan S Pober Journal: Sci Transl Med Date: 2017-11-29 Impact factor: 17.956
Authors: A D Barlow; M O Hamed; D H Mallon; R J Brais; F M Gribble; M A Scott; W J Howat; J A Bradley; E M Bolton; G J Pettigrew; S A Hosgood; M L Nicholson; K Saeb-Parsy Journal: Am J Transplant Date: 2015-05-18 Impact factor: 8.086
Authors: J Moritz Kaths; Juan Echeverri; Yi Min Chun; Jun Yu Cen; Nicolas Goldaracena; Ivan Linares; Luke S Dingwell; Paul M Yip; Rohan John; Darius Bagli; Istvan Mucsi; Anand Ghanekar; David R Grant; Lisa A Robinson; Markus Selzner Journal: Transplantation Date: 2017-04 Impact factor: 4.939