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Perfusion of Porcine Kidneys With Macromolecular Heparin Reduces Early Ischemia Reperfusion Injury
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
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2019 (Engelska)Ingår i: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 103, nr 2, s. 420-427Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Previously, we have been able to demonstrate the possibility of coating the inner surface of the renal arteries in porcine kidneys with a heparin conjugate during hypothermic machine perfusion (HMP). The purpose of this study was to assess the efficacy of this treatment in reducing early ischemia-reperfusion injury.

Method: Brain death was induced in male landrace pigs by stepwise volume expansion of an epidural balloon catheter until negative cerebral perfusion pressure (CPP) was obtained. Both kidneys (matched pairs; n = 6 + 6) were preserved for 20 hours byHMP during which 50mg heparin conjugate was added to one of the HMP systems (treated group). A customized ex vivo normothermic oxygenated perfusion (NP) system with added exogenous creatinine was used to evaluate early kidney function. Blood, urine and histological samples were collected during the subsequent 3 hours of NP.

Results: Kidney weight was lower at the end of NP (P = 0.017) in the treated group compared with control kidneys. The rate of decline in creatinine level was faster (P = 0.024), total urinary volume was higher (P = 0.031), and the level of urine neutrophil gelatinase-associated lipocalin (NGAL) was lower (P = 0.031) in the treated group. Histologically, less tubular changes were seen (P = 0.046). During NP intrarenal resistance remained lower (P < 0.0001) in the treated group.

Conclusions: Perfusion of porcine kidneys with heparin conjugate during HMP reduces preservation injury and improves organ function shortly after reperfusion. No increased risk of bleeding was seen in this setup. This protective strategy may potentially improve the quality of transplanted kidneys in the clinical setting.

Ort, förlag, år, upplaga, sidor
LIPPINCOTT WILLIAMS & WILKINS , 2019. Vol. 103, nr 2, s. 420-427
Nationell ämneskategori
Kirurgi
Identifikatorer
URN: urn:nbn:se:uu:diva-377674DOI: 10.1097/TP.0000000000002469ISI: 000457576600035PubMedID: 30299374OAI: oai:DiVA.org:uu-377674DiVA, id: diva2:1291589
Forskningsfinansiär
VINNOVATillgänglig från: 2019-02-25 Skapad: 2019-02-25 Senast uppdaterad: 2019-02-25Bibliografiskt granskad

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Sedigh, AmirNordling, SofiaLarsson, ErikLubenow, NorbertLennmyr, FredrikTufveson, GunnarMagnusson, PeetraLorant, Tomas

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Sedigh, AmirNordling, SofiaLarsson, ErikLubenow, NorbertLennmyr, FredrikTufveson, GunnarMagnusson, PeetraLorant, Tomas
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TransplantationskirurgiKlinisk immunologiInstitutionen för immunologi, genetik och patologiAnestesiologi och intensivvård
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